静脉注射神经节苷脂致格林巴利综合征文献的回顾分析

Literature analysis of Guillain-Barré syndrome caused by intravenous administration of gangliosides

目的探讨静脉给予神经节苷脂致格林巴利综合征的临床特点、相关性因素以及预防与治疗方法。方法在MED—LINE数据库和EMBASE数据库、OVID医学数据库、Springer期刊数据库、维普资讯网、中国知网数据库、万方数据库检索1990至2014年报道应用神经节苷脂致格林巴利综合征案例，并进行统计分析。结果共选人文献7篇，涉及患者54例，其中男性32例，女性22例。用药原因主要为疼痛、脑血管疾病和周围神经疾病。52例患者资料中记录了应用神经节苷脂至出现格林巴利综合征的时间，中位数为11d。静脉滴注神经节苷脂8～14d发生格林巴利综合征的比例最高（50．00％）。治疗方法包括停止使用神经节苷脂，迅速静脉滴注人血免疫球蛋白或行血浆置换。33例部分或全部恢复，15例无好转，6例死亡。结论神经节苷脂可能导致格林巴利综合征，临床医师应严格掌握适应证，临床药师应加强药学监护，避免不良反应的发生。

AIM To investigate the clinical characteristics, related factors, as well as prevention and treatment of Guillain-Barr6 syndrome caused by intravenous administration of gangliosides. METHODS MEDLINE, EMBASE, OVID, Springer, VIP, CNKI and Wanfang databases were searched. The cases of Guillain-Barr6 syndrome caused by gangliosides between 1990 and 2014 were collected and analyzed. RESULTS A total of 7 references and 54 reports with Guillain-Barr6 syndrome associated with gangliosides were collected. These patients comprised 32 men and 22 women. The main primary medical reasons were pain, cerebrovascular disease and peripheral nervous disease. Totally 52 cases recorded the time from start of gangliosides to onset of syndrome. The median of duration of treatment was 11 days. The highest proportion of the time from start of gangliosides to onset of syndrome was 2 weeks（50.00% ）. The measures of management included drug withdrawal, intravenous blood immunoglobulin or plasma exchange. In 54 reports with descrip- tion of prognosis, 33 cases were partially or completely recovered, 15 cases were no better off, and 6 cases died. CON- CLUSION The intravenous administration of gangliosides may cause Guillain-Barr6 syndrome. Clinicians should strictly grasp the indications, and clinical pharmacists should strengthen the pharmaceutical care to avoid the occurrence of ad- verse drug reactions.