吉兰-巴雷综合征18例临床分析

Clinical Analysis of 18 Cases with Guillain-Barre Syndrome

目的 分析吉兰-巴雷综合征（GBS）患者的临床特征.方法 收集2012年—2017年18例GBS病人,回顾性分析其临床资料,包括临床表现、实验室检查、神经电生理检查、治疗及预后.结果 有12例发病前有感染史,临床症状以四肢乏力麻木常见,亦常累及颅神经,有11例脑脊液出现蛋白-细胞分离现象.有11例患者行肌电图检查,9例结果异常,累及髓鞘、轴索或F波异常.有12例应用免疫球蛋白联合糖皮质激素治疗,5例仅用糖皮质激素治疗,1例未予免疫球蛋白及糖皮质激素治疗,除1例累及呼吸肌者,其余基本预后良好.结论 GBS患者大多发病前有感染史,临床表现多样,脑脊液及肌电图检查异常率高,但早期可无异常,免疫球蛋白疗效确切,联合激素治疗可能效果更佳.

Objective To analyze the clinical characteristics of patients diagnosed as Guillain-Barre syndrome （GBS）. Methods Records of 18 GBS patients admitted between 2012 and 2017 in our hospital were evaluated, including clinical manifestations, laboratory tests, neuroelectrophysiological tests, treatment and prognosis. Results 12 patients had the history of infection before the onset of the disease. The clinical symptoms were usually numbness and weakness of 4 limbs, also including cranial nerves. The laboratory data revealed that 11 patients showed albuminocytologic dissociation in the cerebrospinal fluid. 9 patients in 11 patients showed abnormal electromyography examinations, including myelin sheath, axone, F-wave. 12 patients were treated with intravenous immunoglobulin and corticosteroid. 5 patients were treated with only corticosteroid. 1 patient was treated without intravenous immunoglobulin and corticosteroid. Almost the others had a good prognosis except 1 patient whose respiratory muscle was involved. Conclusion The GBS patients usually had a history of infection before the onset of the disease. In the GBS patients, the clinical manifestations were diverse, the abnormality rate of the cerebrospinal fluid and electromyography examinations were high except sometimes at the early stage of the disease. The intravenous immunoglobulin treatment can achieve satisfactory effect and even make a better prognosis together with the corticosteroid treatment.