Electrophysiological Subtypes and Prognostic Factors of Guillain-Barre Syndrome in Northern China
Electrophysiological Subtypes and Prognostic Factors of Guillain-Barre Syndrome in Northern China
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中国北方地区格林-巴利综合征的电生理亚型及预后因素
DOI：
10.3389/fneur.2019.00714
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发表时间：
2019-07-02
影响因子：
3.4
通讯作者：
Liu, Xiaoyun
中科院分区：
文献类型：
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作者：
Tian, Jing;Cao, Cuifang;Liu, Xiaoyun
目的：了解吉兰-巴雷综合征（GBS）不同电生理亚型的流行病学，探讨中国北方地区急性运动轴索神经病（AMAN）亚型预后的影响因素。方法：根据国家神经疾病与脑卒中诊断标准，于2014 - 2018年在中国河北医科大学第二医院神经内科连续招募104例GBS患者。结果：基于神经传导研究（NCSs）， AMAN是中国北方最常见的亚型，占58例（55.8%）。与急性炎症性脱髓鞘性多神经病变（AIDP）患者相比，AMAN患者既往腹泻发生率明显升高，住院时间更长，恢复稍慢，但AMAN与AIDP患者在疾病严重程度和短期预后方面无统计学差异。多因素回归分析显示，既往腹泻（OR = 0.16, 95% CI: 0.03 ~ 0.756, p = 0.021）或传导阻滞（CBs）的AMAN患者短期预后明显较好（OR = 0.033, 95% CI: 0.001 ~ 0.787, p = 0.035）。远端刺激复合动作电位（dCMAP）幅度降低与恢复速度显著减慢相关（OR = 8.31, 95% CI: 2.55-27.10, p = 0.02）。结论：AMAN仍是中国北方地区最常见的GBS亚型。dCMAP振幅的下降是GBS恢复缓慢和预后不良的预测因素。腹泻和CBs可能是中国北方AMAN患者短期预后较好的因素。
Objectives: To assess the epidemiology of different electrophysiological subtypes of Guillain-Barre syndrome (GBS) and investigate the factors affecting the prognosis of the acute motor axonal neuropathy (AMAN) subtype in northern China. Methods: According to the National Institute of Neurological Disorders and Stroke diagnostic criteria for GBS, 104 consecutive GBS patients were recruited from the Department of Neurology of the Second Hospital of Hebei Medical University, China from 2014 to 2018. Results: Based on nerve conduction studies (NCSs), AMAN was the most common subtype in Northern China, accounting for 58 patients (55.8%). AMAN patients had significantly higher prevalence of antecedent diarrhea, longer duration of hospitalization, and slightly slower recovery than those with acute inflammatory demyelinating polyneuropathy (AIDP), but there was no statistical difference in disease severity or short-term prognosis between AMAN and AIDP. Based on multivariate regression analysis, AMAN patients with antecedent diarrhea (OR = 0.16, 95% CI: 0.03–0.756, p = 0.021) or conduction blocks (CBs) (OR = 0.033, 95% CI: 0.001–0.787, p = 0.035) had dramatically better short-term prognosis. Decreased compound action potential with distal stimulation (dCMAP) amplitude was associated with significant slower speed of recovery(OR = 8.31, 95% CI: 2.55–27.10, p = 0.02). Conclusion: AMAN is still the most common subtype of GBS in northern China. A decline in dCMAP amplitude is predictive factor of a slow recovery and poor outcome of GBS. Diarrhea and CBs may be the factors for better short-term prognosis in AMAN patients in Northern China.