Cheng Q, Jiang G X, Press R, Andersson M, Ekstedt B, Vrethem M, Liedholm L J, Lindsten H, Brattström L, Fredrikson S, Link H, de Pedro-Cuesta J
Division of Neurology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Eur J Neurol. 2000 Nov;7(6):685-92. doi: 10.1046/j.1468-1331.2000.00128.x.
We described clinical manifestations, outcomes, prognostic indicators and clinico-epidemiological subgroups for 53 adult patients with Guillain-Barré syndrome (GBS) in Sweden during the period 1996-97. These patients were identified from a population of 2.8 million inhabitants and prospectively followed up for one year by a network of neurologists. An additional 10 cases, of whom five were adults who had not been prospectively followed up, were not included in the analyses. At 6 months after onset 80% of the patients could walk without aid, while at 1 year 46% were fully recovered, 42% had mild residual signs or symptoms, 4% had moderate and 6% severe disabilities, and 2% had died. Intravenous human immunoglobulin or plasmapheresis were used in 72% of the patients. The sum of the Medical Research Council (MRC) score at nadir was found as the only significant predictor for residual signs at 1 year in a multivariate model. Three subgroups, with different clinico-epidemiological characteristics, were identified by using cluster analysis. In conclusion, GBS in Sweden is frequently preceded by a respiratory infection, is often treated with immunomodulatory therapies, and exhibits a high recovery rate and a low fatality rate.
我们描述了1996 - 1997年期间瑞典53例成年吉兰 - 巴雷综合征(GBS)患者的临床表现、结局、预后指标及临床流行病学亚组情况。这些患者来自280万人口,由一组神经科医生进行前瞻性随访一年。另外10例患者未纳入分析,其中5例成年患者未进行前瞻性随访。发病6个月时,80%的患者无需辅助即可行走;1年时,46%的患者完全康复,42%有轻度残留体征或症状,4%有中度残疾,6%有重度残疾,2%死亡。72%的患者使用了静脉注射人免疫球蛋白或血浆置换。在多变量模型中,最低点时医学研究委员会(MRC)评分总和是1年时残留体征的唯一显著预测因素。通过聚类分析确定了三个具有不同临床流行病学特征的亚组。总之,瑞典的GBS常常在呼吸道感染后发生,常采用免疫调节疗法治疗,且恢复率高、死亡率低。