儿童吉兰-巴雷综合征短期预后的影响因素分析

Short-term prognostic factors for Guillain-Barrésyndrome in children

目的探讨影响儿童吉兰-巴雷综合征(GBS)短期预后的因素。方法回顾性分析自2013年1月1日至2016年9月30日中国淮河以南10个省/直辖市/自治区共24所医院收治的78例GBS患儿的临床资料,探讨影响患儿短期预后的因素。结果78例患儿中男50例,女28例;年龄(9.53±5.44)岁,5岁以下者19例;有前驱事件者50例;颅神经受累者28例,自主神经受累者22例;需要辅助呼吸者5例;住院期间死亡1例。不同年龄、发病至入院天数、临床分型、电生理分型、治疗方案及有无前驱事件、有无颅神经受累患儿间短期预后不良[出院时Hughes GBS残障评分≥3分]比例差异均无统计学意义(P>0.05),但自主神经受累患儿中短期预后不良比例(31.8%)明显高于未受累患儿(10.7%),差异有统计学意义(P<0.05)。结论伴有自主神经受累的儿童GBS的短期预后较差。

Objective To explore the short-term prognostic factors for Guillain-Barrésyndrome(GBS)in children.Methods The clinical data of children with GBS from 24 hospitals in 10 provinces/municipalities/autonomous regions in southern China(south of Huaihe River)from January 1,2013 to September 30,2016 were retrospectively analyzed.The factors affecting the short-term prognoses of children were explored.Results In these 78 children(50 males and 28 females),the average age was 9.53±5.44 years,and 19 were under 5 years old.Fifty children had history of prodromal events;28 children had cranial nerve involvement,and 22 had autonomic nerve involvement.Five children needed assisted respiration,and one died during hospitalization.There was no statistically significant difference in percentage of children having poor short-term prognosis(scores of Hughes GBS disability scale≥3 at discharge)between children with different ages,children having different days from onset to admission,children with different clinical classifications or electrophysiological classifications,children with different treatment plans,children having presence or absence of prodromal events,children having presence or absence of cranial nerve involvement(P>0.05).The proportion of children having poor short-term prognosis in children with autonomic nerve involvement was significantly higher than that of children without autonomic nerve involvement(31.8%vs.10.7%,P<0.05).Conclusion The short-term prognosis of children with autonomic nerve involvement is poor.