激素联合丙种球蛋白治疗慢性吉兰-巴雷综合征临床分析

Analysis of clinical efficacy of methylprednisolone combined with gamma-globulins in the treatment of chronic Guillain-Barre syndrome

目的探讨激素联合丙种球蛋白治疗慢性吉兰-巴雷综合征(chronic Guillian-Barre syndrome,CGBS)的临床疗效。方法选取2010-07—2012-11我院收治的35例CGBS患者,随机分为对照组14例和治疗组21例,2组均给予维生素B1、甲钴胺等常规药物,对照组给予甲基强的松龙递减治疗,治疗组则采用甲基强的松龙和丙种球蛋白联合疗法,治疗6周后比较2组的治疗效果。结果治疗组有效19例,总有效率为90.48%,起效时间(5.14±1.15)d,平均住院时间(28.71±6.46)d;对照组有效8例,总有效率57.14%,起效时间(6.29±1.27)d,平均住院时间(35.07±7.59)d,2组比较差异均有统计学意义(P<0.05),且治疗组感染率显著低于对照组。结论甲基强的松龙联合丙种球蛋白治疗慢性吉兰-巴雷综合征与单用甲基强的松龙相比显效快,能有效缩短住院时间,降低糖皮质激素引起的感染等不良反应,值得临床推广。

Objective To observe and analyze the therapeutic effect of methylprednisolone combined with gamma-globulins on chronic Guillain-Barre syndrome. Methods Thirty-five patients of CGBS were selected according to diagnostic standard and divided into two groups by layer randomized principle. Both of the two groups were given routine medicines such as VitB1 and mecobalamin. The control group was only given methylprednisolone, while the treatment group was given methylprednisolone combined with gamma-globulins. After treatment for six weeks, the clinical efficacy of the two groups was compared. Results The effective cases of treatment group were 19, the total effective rate was 90.48 %,the treatment effect appeared in （5.14 ± 1.15） days, and the average length of hospital stay was （28.71 ± 6.46） days; while the effective cases of control group were 8, the total effective rate was 57.14 %, the treatment effect appeared in （6.29 ±1.27）days, and the average length of hospital stay was （35.07±7.59） days. The data of two groups were statistically different （P〈0.05）, and the infection rate of treatment group was significantly lower than the control group. Conclusion In the treatment on chronic Guillain-Barre syndrome, methylprednisolone combined with gamma-globulins takes action faster and had more significant effect than methylprednisolone alone. Also the combination therapy can reduce the average length of hospital stay, and has no serious adverse effects, which is worth further extension.