不同类型吉兰-巴雷综合征患者的临床表现及预后

The Clinical Features and Prognosis among Patients with Different Types of Guillain-Barré Syndrome

目的:分析不同类型的吉兰-巴雷综合征(GBS)患者的临床表现及预后。方法:以电生理方法将63例患者分为脱髓鞘型、轴索型和未分类型。比较脱髓鞘型和轴索型患者的临床表现、疾病高峰期及出院时的神经功能残疾评分。结果:轴索型和脱髓鞘型患者疾病高峰期神经功能残疾评分分别为(4.0±1.05)分和(2.8±0.98)分,出院时分别为(2.6±1.84)分和(1.3±0.75)分,两组间评分差异有统计学意义(均P<0.01)。轴索型患者有较高比例的前趋期腹泻和呼吸肌麻痹症状发生,但感觉异常少见。结论:轴索型GBS患者易有前躯期腹泻和呼吸肌麻痹的临床表现,其病情重、预后差。

Aim：To observe the clinical features and prognosis among patients with different electro-physiologically defined subtypes of Guillain-Barré syndrome（GBS）.Methods：Sixty-three patients with GBS were divided into demyelination group,axonal neuropathy group and unclassifiable group based on their electrophysiological findings.Their clinical features,scores of the Hughes functional grading scale assessed at the peak of disease and at discharge were compared between the demyelination group and axonal neuropathy group.Results：The Hughes functional grading scale scores in the axonal neuropathy group at the peak of disease and at discharge were（4.0±1.05） and（2.6±1.84）,respectively,which were significantly high than that in the demyelination group（2.8±0.98 and 1.3±0.75,respectively）（P0.01）.The patients in the axonal neuropathy group had significantly high rates of prodromal diarrhea and weakness of the respiratory muscles than the patients in the demyelination group（P0.05）.Conclusion：Acute axonal neuropathy type GBS patients had more prodromal diarrhea,weakness of the respiratory muscles,severe conditions,and poor outcomes than patients with acute demyelination.