论文部分内容阅读
目的探讨Guillain-Barré综合征(GBS)患者临床及CSF细胞学特点。方法回顾性分析37例GBS患者的临床资料。结果本组患者急性起病33例,亚急性起病4例。临床表现为四肢无力18例(48.6%),双下肢无力16例(43.2%),四肢麻木21例(56.8%),双侧面神经麻痹12例(32.4%),其他颅神经损害5例(13.5%),呼吸肌麻痹3例(8.1%),全自主神经功能障碍及Fisher综合征各1例(5.4%);变异型GBS 6例(16.2%)。腰穿CSF检查示4例(10.8%)患者压力高,11例(29.7%)细胞计数升高,29例(78.4%)蛋白升高,7例(18.9%)免疫球蛋白升高。34例(91.9%)CSF细胞学检查异常,22例(64.7%)患者表现为激活的淋巴细胞反应,12例(35.3%)以激活的单核细胞反应为主。感觉或运动神经传导异常25例(67.6%),F波或H反射异常33例(89.2%)。32例患者给予丙种球蛋白或血浆置换治疗,5例给予糖皮质激素治疗,均有效。结论 GBS多数表现为四肢对称性麻木、无力,部分为变异型。F波、H反射电生理检查早期异常率高。CSF细胞学检查早期以淋巴细胞反应为主,后期以单核细胞反应为主。
Objective To investigate the clinical and cytological features of Guillain-Barré syndrome (GBS). Methods The clinical data of 37 patients with GBS were retrospectively analyzed. Results This group of patients with acute onset in 33 cases, subacute onset in 4 cases. The clinical manifestations were weakness of the limbs in 18 cases (48.6%), double lower limb weakness in 16 cases (43.2%), limb numbness in 21 cases (56.8%), bilateral facial paralysis in 12 cases (32.4%) and other cranial nerve lesions in 5 cases %), 3 cases of respiratory muscle paralysis (8.1%), 1 case of autonomic nerve dysfunction and Fisher syndrome (5.4%), 6 cases of variant GBS (16.2%). Lumbar CSF examination showed high pressure in 4 patients (10.8%), elevated cell counts in 11 patients (29.7%), elevated protein in 29 patients (78.4%) and immunoglobulin in 7 patients (18.9%). CSF cytology was abnormal in 34 cases (91.9%), activated lymphocyte reaction in 22 cases (64.7%) and activated monocyte reaction in 12 cases (35.3%). Twenty-five patients (67.6%) had sensory or motor nerve conduction abnormalities, and 33 (89.2%) patients had abnormal F wave or H reflex. 32 patients were given gammaglobulin or plasma exchange treatment, 5 patients given glucocorticoid therapy, are effective. Conclusions Most of the manifestations of GBS limbs symmetry numbness, weakness, part of the variant. F wave, H reflex electrophysiological examination early abnormal rate high. CSF cytology early lymphocyte reaction, monocyte reaction at the end mainly.