Schleicher Gunter K, Black Andrew, Mochan Andre, Richards Guy A
Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Crit Care Med. 2003 Jun;31(6):1848-50. doi: 10.1097/01.CCM.0000069516.81522.F4.
The primary objective of this study was to investigate the effect of human immunodeficiency virus (HIV) infection on the outcome of patients admitted to the intensive care unit (ICU) with severe Guillain-Barré syndrome (GBS) requiring mechanical ventilation. A secondary objective was to compare the clinical and laboratory features of HIV-seronegative and HIV-seropositive patients admitted to the ICU with severe GBS.
Retrospective chart review.
Two tertiary, academic hospitals in Johannesburg, South Africa.
The case records of all patients admitted to the ICU with GBS between January 1995 and June 2002 were reviewed. Patients were included if their HIV status was known and if they had clinical features, electrophysiologic studies, and cerebrospinal fluid analyses consistent with GBS. Demographic data, days in ICU, days ventilated, CD4 T-lymphocyte counts (in the HIV group), cerebrospinal studies, infection rate, and mortality data were analyzed.
A total of 13 patients met the inclusion criteria: seven were HIV seronegative and six were HIV seropositive. The median age in the HIV group was 34.5 yrs, compared with 47 yrs in the non-HIV group. There was no significant difference between the two groups in days spent in the ICU or days ventilated. There were no significant differences in cerebrospinal studies, electrophysiologic studies, and blood culture-positive infections between the two groups. All patients received intravenous immunoglobulin (0.4 g/kg/day for 5 days). There was one death in the HIV-seropositive group and no deaths in the HIV-seronegative group. The median CD4 T-lymphocyte count in the HIV group was 322.5 x 106 cells/L.
HIV is commonly associated with GBS in South Africa. The ICU outcome in patients with HIV-associated GBS is similar to HIV-seronegative patients, particularly if the CD4 T-lymphocyte count is greater than 200 x 106 cells/L at admission.
本研究的主要目的是调查人类免疫缺陷病毒（HIV）感染对因严重吉兰 - 巴雷综合征（GBS）需要机械通气而入住重症监护病房（ICU）的患者预后的影响。次要目的是比较入住ICU的HIV血清阴性和HIV血清阳性的严重GBS患者的临床和实验室特征。
回顾性病历审查。
南非约翰内斯堡的两家三级学术医院。
回顾了1995年1月至2002年6月期间所有因GBS入住ICU的患者的病历。如果患者的HIV状态已知，并且具有与GBS一致的临床特征、电生理研究和脑脊液分析结果，则纳入研究。分析了人口统计学数据、在ICU的天数、通气天数、CD4 T淋巴细胞计数（HIV组）、脑脊液研究、感染率和死亡率数据。
共有13名患者符合纳入标准：7名HIV血清阴性，6名HIV血清阳性。HIV组的中位年龄为34.5岁，非HIV组为47岁。两组在ICU住院天数或通气天数方面无显著差异。两组在脑脊液研究、电生理研究和血培养阳性感染方面无显著差异。所有患者均接受静脉注射免疫球蛋白（0.4 g/kg/天，共5天）。HIV血清阳性组有1例死亡，HIV血清阴性组无死亡。HIV组的中位CD4 T淋巴细胞计数为322.5×10⁶细胞/L。
在南非，HIV常与GBS相关。HIV相关GBS患者的ICU预后与HIV血清阴性患者相似，特别是如果入院时CD4 T淋巴细胞计数大于200×10⁶细胞/L。
