云南大理地区吉兰-巴雷综合征临床及神经电生理特点的单中心研究

Single center study on clinical and neuroelectrophysiological characteristics of Guillain-Barre syndrome in Dali region of Yunnan Province

目的:探讨云南大理地区吉兰-巴雷综合征(GBS)的临床及神经电生理特点。方法:对2012年1月至2019年12月就诊于大理大学第一附属医院的63例GBS患者的临床资料及神经电生理结果进行回顾性分析。根据临床及电生理表现分为经典GBS型,即急性炎症性脱髓鞘性多发神经病(AIDP)和其他亚型。结果:云南大理地区GBS患者以中青年居多,前驱感染以呼吸道及消化道感染史最常见,临床首发症状以四肢对称性无力最常见。通过对神经电生理检测结果的分析总结,最终诊断经典型GBS(AIDP)16例(25.4%),急性运动轴索性神经病(AMAN)15例(23.8%),急性运动感觉轴索性神经病(AMSAN)22例(34.9%),Miller-Fisher综合征(MFS)5例(7.9%),急性感觉神经病(ASN)2例(3.2%),Bickerstaff脑干脑炎(BBE)合并GBS 2例(3.2%),颈-咽-臂型1例(1.6%)。电生理以复合肌肉动作电位降低、F波及H反射异常为主要表现。结论:云南大理地区GBS以AMSAN、AIDP、AMAN为主要类型,其临床及电生理表现具有一定的特殊性,神经电生理检测对于早期诊断GBS及分型、判断预后具有重要价值。

Objective:To explore the clinical and neuroelectrophysiological characteristics of Guillain-Barre syndrome(GBS)in Dali region of Yunnan Province.Methods:The clinical data and neuroelectrophysiological results of 63 patients with GBS admitted to the First Affiliated Hospital of Dali University from January 2012 to December 2019 were retrospectively analyzed.According to the clinical and electrophysiological features,they were divided into classic GBS type,namely acute inflammatory demyelinating polyneuropathy(AIDP)and other subtypes.Results:Analysis of age distribution revealed a high incidence among young adult patients.The history of respiratory tract and digestive tract infection is the most common precursor infection.Symmetrical weakness of limbs is the most common clinical first symptom.Through the analysis and summary of the results of neuroelectrophysiology,the final diagnosis was made in 16 cases(25.4%)with typical GBS(AIDP),15 cases(23.8%)with acute motor axonal neuropathy(AMAN),22 cases(34.9%)with acute motor sensory axonal neuropathy(AMSAN),5 cases(7.9%)with Miller-Fisher syndrome(MFS),2 cases(3.2%)with acute sensory neuropathy(ASN),2 cases(3.2%)with Bickerstaff brainstem encephalitis(BBE),1 case(1.6%)with neck-pharyngeal-arm type.The main electrophysiological manifestations were decreased compound muscle action potential and abnormal F wave and H reflex.Conclusions:AMSAN,AIDP and AMAN are the main subtypes of GBS in Dali area.The clinical and electrophysiological manifestations have certain particularity.The detection of neuroelectrophysiology has important value for early diagnosis,classification and prognosis of GBS.