慢性吉兰-巴雷综合征甲基强的松龙联合丙种球蛋白治疗临床观察

Effect of methylprednisolone combined with globulin on chronic Guillain-Barré syndrome

目的慢性吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)是一种周围神经炎症脱髓鞘类疾病,治疗困难,以往临床常使用激素治疗,但效果欠佳。本研究探讨甲基强的松龙联合丙种球蛋白治疗慢性GBS的效果。方法选取2016-01-01-2017-04-30齐齐哈尔医学院第二附属医院收治的68例慢性GBS患者作为研究对象。对照组34例,给予甲基强的松龙进行治疗;试验组34例,在对照组治疗基础上联合丙种球蛋白进行治疗。观察两组治疗效果、起效时间、住院时间、并发症发生情况以及患者满意度等指标。结果试验组治疗总有效率为94.1%,高于对照组的70.6%,差异有统计学意义,χ~2=6.476,P=0.011;试验组住院时间为(26.37±5.48)d,短于对照组的(36.37±8.33)d,差异有统计学意义,t=5.848,P=0.001;治疗起效时间为(4.01±0.82)d,短于对照组的(7.14±1.68)d,差异有统计学意义,t=9.763,P<0.001;试验组感染、心电图异常、胃肠不适、面部浮肿、肝功能异常及失眠等并发症发生情况少于对照组,差异有统计学意义,均P<0.05;试验组满意率为91.2%,高于对照组的64.7%,差异有统计学意义,χ~2=6.928,P=0.009。结论甲基强的松龙联合丙种球蛋白治疗慢性GBS效果好,不良反应少。

OBJECTIVE Chronic Guillain-Barrésyndrome(GBS)is a demyelinating disease of peripheral nerve inflammation.It is difficult to treat the disease.Hormones are often used in the past to treat the disease,but the effect is not good.This study is to investigate the effect of methylprednisolone combined with gamma globulin in the treatment of chronic GBS.METHODS A total of 68 patients with chronic GBS admitted to the Second Affiliated Hospital of Qiqihar Medical College from January 1,2016 to April 30,2017 were selected as the study subjects.34 patients in the control group were treated with methylprednisolone.34 patients in the experimental group were treated with gamma globulin on the basis of the treatment in the control group.The therapeutic effect,onset time,hospital stay,complications and patient satisfaction of the two groups were observed.RESULTS The total effective rate was 94.1%in the experimental group,which was higher than 70.6%in the control group.The difference was statistically significant,χ^2=6.476,P=0.011.The length of hospitalization in the experimental group was(26.37±5.48)d,shorter than that in the control group(36.37±8.33)d,t=5.848,P=0.001.The onset time of treatment was(4.01±0.82)d,shorter than that in the control group(7.14±1.68)d,the difference was significant,t=9.763,P<0.001.Complications such as infection,abnormal electrocardiogram,gastrointestinal discomfort,facial edema,abnormal liver function and insomnia in the experimental group were less than those in the control group,with statistical significance,all P<0.05.The satisfaction rate of the experimental group was 91.2%,higher than 64.7%of the control group,with statistical significance,χ^2=6.928,P=0.009.CONCLUSION Methylprednisolone combined with gamma globulin in the treatment of chronic GBS has good effect and less adverse reactions.