Department of Neurology, Kindai University, Faculty of Medicine, Osaka-sayama, Japan.
Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.
J Peripher Nerv Syst. 2017 Dec;22(4):433-439. doi: 10.1111/jns.12234. Epub 2017 Sep 11.
Guillain-Barré syndrome (GBS) is an acute monophasic neuropathy. Prognostic tools include the modified Erasmus GBS outcome score (mEGOS), Erasmus GBS respiratory insufficiency score (EGRIS), and the increase in serum IgG levels (ΔIgG) 2 weeks after intravenous immunoglobulin (IVIg) treatment. Given that proportions of GBS subtypes differ between Western countries and Japan, the usefulness of these tools in Japan or other countries remains unknown. We enrolled 177 Japanese patients with GBS from 15 university hospitals and retrospectively obtained mEGOS and EGRIS for all and ΔIgG status for 79 of them. High mEGOS scores on admission or on day 7 were significantly associated with poorer outcomes (unable to walk independently at 6 months). High EGRIS scores (≥5 points) were associated with an increased risk for mechanical ventilation. Patients with ΔIgG <1,108 mg/dl had significantly poorer outcomes. We suggest that mEGOS, EGRIS, and ΔIgG in GBS are clinically relevant in Japan.
格林-巴利综合征（GBS）是一种急性单相神经病。预后工具包括改良的 Erasmus GBS 结局评分（mEGOS）、Erasmus GBS 呼吸功能不全评分（EGRIS）和静脉注射免疫球蛋白（IVIg）治疗后 2 周血清 IgG 水平升高（ΔIgG）。鉴于西方国家和日本的 GBS 亚型比例不同，这些工具在日本或其他国家的有用性尚不清楚。我们从 15 所大学医院招募了 177 名日本 GBS 患者，回顾性地为所有患者获得 mEGOS 和 EGRIS，为 79 名患者获得 ΔIgG 状态。入院时或第 7 天的高 mEGOS 评分与较差的结局显著相关（6 个月时无法独立行走）。高 EGRIS 评分（≥5 分）与机械通气风险增加相关。ΔIgG<1,108mg/dl 的患者结局明显较差。我们建议 mEGOS、EGRIS 和 ΔIgG 在日本的 GBS 中具有临床相关性。
