儿童吉兰-巴雷综合征的临床和电生理特点及其与预后的相关性研究

    Clinical and electrophysiological features of Guillain-Barre syndrome and their correlations with prognosis in children

    • 摘要: 目的:研究儿童吉兰-巴雷综合征(Guillian-Barre syndrome,GBS)的临床和电生理特点及其与预后的相关性。方法:回顾性分析62例GBS患儿的临床资料(包括:性别、发病年龄、发病季节、前驱感染、临床症状、脑脊液检查)和神经电生理检查结果,随访可以电话联系者40例,探讨这些临床和电生理特点与预后(至少发病1年后)的相关性。结果:62例患儿男女比例为2.4:1,发病年龄3个月至15岁。66.1%患儿有明确诱因,以上呼吸道感染为主(61.3%)。不同肌电图分型、颅神经和自主神经功能受累患儿其远期预后差异均无统计学意义(P>0.05)。病情高峰时Hughes评分≥3分、病程中有呼吸肌受累患儿其远期预后均差于评分<3分和无呼吸肌受累患儿(P<0.05)。部分恢复患儿发病年龄明显大于完全恢复患儿(P<0.01)。结论:儿童GBS有一定的临床特点,其中病情高峰时Hughes评分≥3分、病程中有呼吸肌受累、发病年龄高提示预后不良。

       

      Abstract: Objective:To study the clinical and electrophysiological features of Guillain-Barre syndrome(GBS),and their correlation with prognosis in children.Methods:The clinical data of sex,age of onset,season of onset,forerunner infection,clinical symptoms and cerebrospinal fluid examination,and electrophysiological result of nerve were retrospectively analyzed in 62 children with GBS.The correlation of the clinical and electrophysiological features with prognosis(at least 1 year after onset) in 40 children with GBS was investigated.Results:Among 62 children with GBS,the ratio of male to female was 2.4 to 1,and the age scope was from 3 months to 15 years old.The 66.1% of cases had definitive inducements,and the most frequent inducement was upper respiratory tract infection(61.3%).The differences in GBS children with different electromyography typing,cranial and autonomic nerves function injury and long-term prognosis were not statistically significant(P>0.05).The Hughes score was more than or equal to at the time of serious condition.The long-term prognosis in GBS children with the involvement of respiratory muscle was worse than that in GBS children with Hughes score <3 or without the involvement of respiratory muscle(P<0.05).The onset age in partial recovery case was significantly more than that in complete recovery case(P<0.01).Conclusions:The GBS child has certain clinical feature,which includes that Hughes score is more than or equal to 3 at the time of serious condition,respiratory muscle is involved,and the high age at onset can result in the imperfect prognosis.

       

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