194例吉兰巴雷综合征患者的临床特点分析

A Study on the Clinical Features of 194 Cases of Guillain-Barre Syndrome

目的:研究吉兰-巴雷综合征(Guillain-Barre Syndrome,GBS)患者的的临床特点,分析GBS病情严重程度的影响因素。方法:回顾性分析西京医院2011年9月至2016年1月收治的194例GBS患者的病历资料,分析GBS患者的人口学特征及临床特点及与病情轻重、是否需要机械通气相关的因素。结果:194例GBS患者中,男性多于女性,青中年发病比例最高,平均年龄为42.91±17.72岁,秋夏季为高发季节,前驱事件以呼吸道感染最多见,首发症状以运动障碍最多见,需要机械通气者占12.37%(24/194)。发病高峰期重型患者占58.76%(114/194)。临床分型中最多见分型为纯运动型77.84%(151/194)。通过对GBS患者起病急性期病情轻型与重型两种分型临床资料的比较发现,有无运动障碍、有无颅神经损伤、是否需要机械通气、高峰期MRC、高峰期Hughes评分5种因素在两组间差异有统计学意义(P<0.05)。在GBS患者机械通气及非机械通气两组之间,运动障碍、病情轻重、高峰期MRC评分、高峰期Hughes评分4种因素在两组间差异有统计学意义(P<0.05)。结论:GBS患者男性多于女性,秋夏季为高发季节,轴索型为主要电生理分型。急性期有无运动障碍、高峰期MRC、高峰期Hughes评分3种因素为影响病情轻重及是否需要机械通气的共同影响因素。

Objective： To study the clinical features of GBS and the influencing factors of GBS severity. Methods： The clinical data of 194 cases of GBS patients treated in Xijing Hospital from September 2011 to January 2016 were retrospective analyzed. The influencing factors of GBS severity, mechanical ventilation were analyzed by chi-square test and t-test. Results： In the 194 cases of GBS patients, male were more than female. Young adult patients had the main proportion in all the patients. The average age is 42.91 ± 17.72 years. Autumn and summer are the highest incidence seasons. Respiratory infection is the most common precursor events（63 cases）.Movement disorders are the most common first symptoms（128 cases）. Patients with mechanical ventilation are 12.37 %（24/194）. Severe patients at nadir are 58.76 %（114/194）. Pure motor of clinical classification is the most common subtype 77.84 %（151/194）. Through the single factor analysis, movement disorders, cranial nerve involvement, mechanical ventilation, the MRC score at nadir, the Hughes score at nadir are significantly different（P〈0.05） between the mild and severity at acute onset of disease. The severity of disease, movement disorders, the MRC score at nadir, the Hughes score at nadir show statistical difference（P〈0.05） between the mechanical ventilation and the non mechanical ventilation. Conclusions： Male are more than female in GBS patients. Autumn is the highest season of disease incidence. Axonal subtype is the main electrophysiological subtype. Movement disorders, the MRC score, and the Hughes score at nadir are influencing factors for the mechanical ventilation and the severity of GBS.