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格林-巴利综合征后神经超声、电生理与临床检查结果的相关性。

Correlation of nerve ultrasound, electrophysiological, and clinical findings in post Guillain-Barré syndrome.

机构信息

Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany.

出版信息

J Peripher Nerv Syst. 2013 Sep;18(3):232-40. doi: 10.1111/jns5.12037.

Abstract

We aimed to correlate functional disability, electrophysiology, and nerve ultrasound in patients after Guillain-Barré syndrome (GBS). Seventy-five healthy controls and 41 post-GBS patients (mean 3.4 years, SD ± 2.91 years after onset) underwent clinical, sonographic, and electrophysiological evaluation. Compared to healthy controls, the post-GBS patients showed: (1) a mean Rasch-built Overall Disability Scale score of 31.8 (SD ± 11.6), modified Rasch-built fatigue severity scale score of 15.6 (SD ± 3.2), Medical Research Council sum score of 22 (SD ± 5.6); (2) electrophysiological signs of permanent axonal loss in the majority of the peripheral nerves; (3) sonographical evidence of higher cross-sectional area values (CSA) of the ulnar (elbow, p < 0.001), radial (spiral groove, p < 0.001), tibial nerve (popliteal fossa, p < 0.001) and brachial plexus (supraclavicular space, p < 0.001). No correlation between sonographic and electrophysiological findings was found. Neither nerve ultrasound nor electrophysiology correlated with muscle strength, overall disability, and fatigue scale. Compared to healthy controls, post-GBS patients had significant functional disability. Despite significant abnormalities in both electrophysiology and ultrasound compared to healthy controls, neither electrophysiology nor nerve ultrasound correlated with functional disability of these patients.

摘要

我们旨在探讨格林-巴利综合征(GBS)后患者的功能障碍、电生理学和神经超声之间的相关性。75 名健康对照者和 41 名 GBS 后患者(平均发病后 3.4 年,标准差 ± 2.91 年)接受了临床、超声和电生理评估。与健康对照者相比,GBS 后患者表现为:(1)Rasch 构建的总体残疾量表评分为 31.8(标准差 ± 11.6),改良 Rasch 构建的疲劳严重程度量表评分为 15.6(标准差 ± 3.2),医学研究委员会总评分 22(标准差 ± 5.6);(2)大多数周围神经存在永久性轴索损失的电生理表现;(3)超声显示尺神经(肘,p<0.001)、桡神经(螺旋沟,p<0.001)、胫神经(腘窝,p<0.001)和臂丛(锁骨上窝,p<0.001)的横截面积(CSA)值较高。超声和电生理检查结果之间没有相关性。神经超声和电生理学均与肌肉力量、整体残疾和疲劳量表无关。与健康对照者相比,GBS 后患者的功能障碍明显。尽管与健康对照者相比,电生理学和超声均存在明显异常,但电生理学和神经超声均与这些患者的功能残疾无关。

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