Amin Bipin, Meghnathi Himanshu, Gajjar M D, Patel Tarak, Vanani Jignesh, Gupta Nidhi, Chauhan Anil
Head of Unit and Professor, Department of Medicine.
Resident Doctor.
J Assoc Physicians India. 2017 Nov;65(11):14-15.
Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy causing acute flaccid paralysis and it is known to improve with plasmapheresis.
To study effects of electrophysiological type of GBS, clinical variant of GBS and time taken for initiation of plasmapheresis on outcome of disease.
50 consecutive patients of GBS attending tertiary care hospital underwent clinical examination and electrophysiological studies. Disability grade was calculated and patients were observed for full functional recovery for 6 months.
In this study, patients in whom plasmapheresis was started within 7 days (n=39) were observed to have significantly better improvement in terms of smaller peak disability and rapid functional recovery compared to those in whom plasmapheresis was started after 7 days (n=11). (p<0.002). Demyelinating pattern on electrophysiology was observed to have better outcome in terms of all parameters compared to axonal. AIDP variant was observed to have best outcome and AMSAN variant was associated with worst outcome.
Rapid institution of plasmapheresis is the most important outcome determining factor. Irrespective of the variant specific comorbidity, early plasmapheresis improves outcome in all parameters.
吉兰 - 巴雷综合征（GBS）是一种导致急性弛缓性麻痹的自身免疫性多发性神经病，已知血浆置换可使其改善。
研究GBS的电生理类型、GBS的临床变异型以及开始血浆置换的时间对疾病预后的影响。
50例连续入住三级医院的GBS患者接受了临床检查和电生理研究。计算残疾等级，并观察患者6个月的完全功能恢复情况。
在本研究中，与血浆置换在7天后开始的患者（n = 11）相比，血浆置换在7天内开始的患者（n = 39）在峰值残疾较小和功能恢复较快方面有显著更好的改善。（p < 0.002）。与轴索性相比，电生理上的脱髓鞘模式在所有参数方面预后更好。观察到急性炎症性脱髓鞘性多发性神经病（AIDP）变异型预后最佳，急性运动轴索性神经病（AMSAN）变异型预后最差。
快速进行血浆置换是最重要的预后决定因素。无论变异型特异性合并症如何，早期血浆置换均可改善所有参数的预后。
