郝佳妮, 屈洪党, 赵亨. 空腹血糖水平与吉兰巴雷综合征短期预后的关系[J]. 蚌埠医学院学报, 2021, 46(5): 635-638. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.019
    引用本文: 郝佳妮, 屈洪党, 赵亨. 空腹血糖水平与吉兰巴雷综合征短期预后的关系[J]. 蚌埠医学院学报, 2021, 46(5): 635-638. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.019
    HAO Jia-ni, QU Hong-dang, ZHAO Heng. Relationship between fasting plasma glucose level and short-term prognosis of Guillain-Barré syndrome[J]. Journal of Bengbu Medical College, 2021, 46(5): 635-638. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.019
    Citation: HAO Jia-ni, QU Hong-dang, ZHAO Heng. Relationship between fasting plasma glucose level and short-term prognosis of Guillain-Barré syndrome[J]. Journal of Bengbu Medical College, 2021, 46(5): 635-638. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.019

    空腹血糖水平与吉兰巴雷综合征短期预后的关系

    Relationship between fasting plasma glucose level and short-term prognosis of Guillain-Barré syndrome

    • 摘要:
      目的探究针对空腹血糖(fasting plasma glucose,FPG)水平异常与吉兰-巴雷综合征(Guillain-Barré syndrome,GBS)的相关性,分析FPG升高是否为GBS病人短期预后不良的独立危险因素。
      方法回顾性分析146例GBS病人临床资料,根据FPG水平分为正常FPG组(n=90)和高FPG组(n=56)。比较2组性别、年龄、神经系统体征、有无前驱感染史、是否合并颅神经麻痹、感觉障碍、自主神经受累、呼吸费力、MRC总分和休斯功能分级量表(Hughes functional grading scale,HFGS)评分等基本资料。分析2组脑脊液蛋白水平、葡萄糖水平、有无蛋白细胞分离、潘氏试验结果等生化资料以及神经电生理资料差异。根据病人出院时HFGS评分分为轻型组(HFGS≤3分)和重型组(HFGS>3分),分析FPG水平与GBS短期预后的关系。
      结果2组病人年龄、性别、前驱感染史、感觉障碍、腱反射减弱或消失、脑膜刺激征、神经电生理分型及脑脊液蛋白水平、蛋白细胞分离和潘氏试验结果差异均无统计学意义(P>0.05)。正常FPG组病人手术外伤史发生率、颅神经受累率、合并自主神经功能障碍率、呼吸困难发生率、辅助通气率、巴氏征发生率、出院时HFGS评分为5和6、脑脊液葡萄糖浓度均低于高FPG组(P < 0.05~P < 0.01),高峰时MRC评分明显低于高FPG组(P < 0.01)。单因素分析显示,年龄大、颅神经受累、自主神经功能障碍、脑脊液蛋白含量高、FPG水平高以及血C反应蛋白水平高均是GBS病人短期预后不良的危险因素(P < 0.05~P < 0.01),脑脊液细胞数与病人短期预后无明显相关性(P>0.05)。多因素logistic回归分析显示,年龄大、颅神经受累、脑脊液蛋白含量高和FPG水平高均为GBS病人短期预后不良的独立危险因素(P < 0.05~P < 0.01)。
      结论FPG升高的GBS病人病情更重、更易出现颅神经受累、自主神经功能障碍、呼吸困难和依赖机械通气,短期预后更差。FPG升高是GBS病人短期预后不良的独立危险因素。

       

      Abstract:
      ObjectiveTo investigate the correlation between abnormal fasting plasma glucose(FPG) level and Guillain-Barré syndrome(GBS), and to analyze whether elevated FPG level being an independent risk factor for poor short-term prognosis in patients with GBS.
      MethodsThe clinical data of 146 patients with GBS were retrospectively analyzed.According to the FPG level, the patients were divided into normal FPG group(n=90) and high FPG group(n=56).Gender, age, neurological signs, history of precursor infection, cranial nerve palsy, sensory disturbance, autonomic nerve involvement, difficulty breathing, total score of MRC and Hughes functional grading scale(HFGS) score were compared between the two groups.The differences of protein level, glucose level, protein-cell separation, Pandy test results in cerebrospinal fluid and electrophysiological data between the two groups were analyzed.According to the HFGS score at discharge, the patients were divided into mild group(HFGS score ≤ 3 points) and severe group(HFGS score>3 points).The relationship between FPG level and short-term prognosis of GBS was analyzed.
      ResultsThere were no significant differences in age, sex, history of precursor infection, sensory disturbance, decrease or absence of tendon reflex, meningeal irritation sign, neuroelectrophysiological classification and protein level, protein-cell separation, Pandy test results in cerebrospinal fluid between the two groups(P>0.05).The incidence of surgical trauma history, cranial nerve involvement, combination of autonomic nerve dysfunction, difficulty breathing, assisted-ventilation, Babinski sign, HFGS score of 5 and 6 at discharge, and glucose concentration in cerebrospinal fluid in normal FPG group were higher than those in high FPG group(P < 0.05 to P < 0.01), and MRC score at nadir was significantly lower than that in high FPG group(P < 0.01).Univariate analysis showed that age, cranial nerve involvement, autonomic nerve dysfunction, and high protein content, high FPG level, high serum C reactive protein level in cerebrospinal fluid were risk factors of poor short-term prognosis in GBS patients(P < 0.05 to P < 0.01);the cell number in cerebrospinal fluid was not significantly correlated with short-term prognosis in GBS patients(P>0.05).Multivariate logistic regression analysis showed that high age, cranial nerve involvement, and high protein level, high FPG level in cerebrospinal fluid were independent risk factors for poor short-term prognosis in GBS patients(P < 0.05 to P < 0.01).
      ConclusionsGBS patients with elevated FPG level are more severe, more likely to have cranial nerve involvement, autonomic nerve dysfunction, difficulty breathing, dependence on mechanical ventilation, and worse short-term prognosis.Elevated FPG level is an independent risk factor for poor short-term prognosis in patients with GBS.

       

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