Sung Eun Jung, Kim Dae Yul, Chang Min Cheol, Ko Eun Jae
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2016 Jun;40(3):481-8. doi: 10.5535/arm.2016.40.3.481. Epub 2016 Jun 29.
To identify the factors that could predict the functional outcome in patients with the axonal type of Guillain-Barre syndrome (GBS).
Two hundred and two GBS patients admitted to our university hospital between 2003 and 2014 were reviewed retrospectively. We defined a good outcome as being "able to walk independently at 1 month after onset" and a poor outcome as being "unable to walk independently at 1 month after onset". We evaluated the factors that differed between the good and poor outcome groups.
Twenty-four patients were classified into the acute motor axonal neuropathy type. There was a statistically significant difference between the good and poor outcome groups in terms of the GBS disability score at admission, and GBS disability score and Medical Research Council sum score at 1 month after admission. In an electrophysiologic analysis, the good outcome group showed greater amplitude of median, ulnar, deep peroneal, and posterior tibial nerve compound muscle action potentials (CMAP) and greater amplitude of median, ulnar, and superficial peroneal sensory nerve action potentials (SNAP) than the poor outcome group.
A lower GBS disability score at admission, high amplitude of median, ulnar, deep peroneal, and posterior tibial CMAPs, and high amplitude of median, ulnar, and superficial peroneal SNAPs were associated with being able to walk at 1 month in patients with axonal GBS.
确定可预测轴索性吉兰-巴雷综合征(GBS)患者功能预后的因素。
回顾性分析2003年至2014年期间入住我校附属医院的202例GBS患者。我们将良好预后定义为“发病后1个月能够独立行走”,不良预后定义为“发病后1个月不能独立行走”。我们评估了良好和不良预后组之间存在差异的因素。
24例患者被归类为急性运动轴索性神经病类型。良好和不良预后组在入院时的GBS残疾评分、入院后1个月时的GBS残疾评分和医学研究委员会总分方面存在统计学显著差异。在电生理分析中,良好预后组的正中神经、尺神经、腓深神经和胫后神经复合肌肉动作电位(CMAP)的波幅以及正中神经、尺神经和腓浅感觉神经动作电位(SNAP)的波幅均高于不良预后组。
轴索性GBS患者入院时较低的GBS残疾评分、正中神经、尺神经、腓深神经和胫后神经CMAP的高波幅以及正中神经、尺神经和腓浅神经SNAP的高波幅与发病后1个月能够行走相关。