老年格林-巴利综合征16例临床分析

The clinical analysis of 16 elderly patients with Guillain-Barre'Syndrome

目的 探讨老年格林 巴利综合征 (GBS)的临床特点。方法 将 5年收治的 98例GBS ,分为老年期 (≥ 60岁 )、成年期 ( 15～ 59岁 )。采用 χ2 检验比较二组资料。结合文献讨论老年GBS的临床特点、诊断及伴发多脏器损害的机制。结果 老年GBS的构成较小占 16.3 % ,男性发病多于女性 (男∶女 =3∶1) ,以四肢瘫痪首发者居多 ,颅神经麻痹以Ⅸ、Ⅹ居多 ,Ⅶ少见 ,客观检查浅感觉缺失者居多。临床表现的严重程度 ,除了与前驱感染因素诱导的免疫反应有关外 ,老年人免疫功能的低下也是其重要原因。结论 老年GBS的诊断在依照经典的GBS诊断标准的同时 ,应考虑到它所具有的特殊临床特征。老年GBS合并症多 ,除了对原发病GBS的基础治疗外 ,尚需注意心、肺、肝。

Objective The clinical characteristics of Guillain Barre'Syndrome(GBS) were studied in the elderly patients.Method The patients with GBS were divided into elderly GBS(≥60 y) and adult GBS(15～59 y).The χ 2 test was adapted to compare the information between above two groups.The clinical characteristics,diagnosis and theory of more organs injury in elderly GBS were studied on binding refernces.Results Elderly GBS patients are less in the total patients (16.3%).There are more male patients than female ones in elderly GBS group (男∶女=3∶1).In this group,most patients suffer from four limbs paralysis as the frist symptom.They suffer from 9th and 10th of cerebronever with paralysis more than 7th N.The objective examination shows more patients suffer from shallow feeling lack.Except that the serious degree of clinical behaviour has relation to induction of immune reaction of pre infective factors,the immunodeficiency of elderly patients is imprtant reasons too.Conclution The diagnosis of elderly GBS acts in accordance with its special clinical characteristics,in the meantime,the elderly GBS must obey the classics diagnostic standards.More complicated symptoms of elderly GBS are found,so the comprehensive treatment of injuries of such organs as heart,lung,liver and brain should be paid more attention to besides elementary treatment of original GBS.