中国东北部吉兰-巴雷综合征临床及电生理表现

Clinical and electrophysiological features of Guillain-Barre syndrome in northeast China

目的描述中国东北部吉兰-巴雷综合征（GBS）的临床、神经电生理表现。方法收集138例确诊GBS的患者,回顾性分析其临床及神经电生理结果。结果中国东北部GBS患者以中青年居多,前驱感染以消化道感染史最常见,临床首发症状以四肢同时出现无力最常见,急性炎症性脱髓鞘性多发性神经病（AIDP）为主要类型,且患者起病症状较重。静脉注射免疫球蛋白（IVIg）对GBS起病2 w后及轻型患者均有效。电生理上以复合肌肉动作电位（CMAP）波幅降低、F波及H反射异常为主要表现,且起病7 d内、7-14 d及14 d后电生理表现无显著差异。结论中国东北部GBS有独特的临床及电生理表现,早期进行电生理检查有助于早期诊断GBS。

Objective To describe clinical,electrophysiological,and therapeutic features of Guillain-Barre syndrome（ GBS） in Northeast China. Methods The clinical and electrophysiological data were collected and reviewed retrospectively in 138 patients hospitalized for GBS. Results Analysis of age distribution revealed a high incidence among young adult patients. Gastroenteritis was the predominant previous infection. The initial and main symptom was hypotonic muscle weakness of the lower extremities,particularly,weakness in all four limbs simultaneously. Acute inflammatory demyelinating polyneuropathy（ AIDP） was the main subtype of GBS in Northeast China. Intravenous immunoglobulin（ IVIg） was effective for patients beyond two weeks of symptom onset and for mildly affected patients. Low compound muscle action potential（ CMAP） amplitudes,abnormal H reflexes,and F waves were the main features of neurophysiological studies. In addition,no statistical differences in electrophysiological features were found between patients within seven days of onset,as well as 8 -14 days and 14 days after GBS onset. Conclusion GBS in Northeast China has characteristic clinical and electrophysiological features. Early neurophysiological studies are helpful for diagnosis of GBS.