Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotića 6, Belgrade, 11129, Serbia.
Physical Medicine and Rehabilitation Clinic, Clinical Center of Serbia, Belgrade, Serbia.
Ir J Med Sci. 2021 Feb;190(1):357-361. doi: 10.1007/s11845-020-02310-7. Epub 2020 Jul 14.
There are no many data on association between progression rate of Guillain-Barré syndrome (GBS) and disease outcome.
The aim of our study was to analyze short-term outcome of GBS in relation to the rate of disease progression.
Our retrospective study included patients diagnosed with GBS in seven tertiary healthcare centers from 2009 to 2014. According to the rate of disease progression from onset of symptoms to the nadir, patients were divided in three groups: rapid-onset GBS (nadir reached in maximum 48 h), gradual-onset (nadir reached in three to 14 days), and slow-onset (nadir in 15 to 28 days). GBS disability scale (GDS) was used to assess functional disability at nadir and on discharge.
Among 380 patients included in the study, 24 (6.3%) patients had rapid-onset, 274 (72.1%) gradual-onset, and 82 (21.6%) slow-onset GBS. Time from the onset of the disease to the hospital admission was much shorter in faster-onset forms (3.0 ± 4.1 days in rapid-onset vs. 6.8 ± 9.5 days in gradual-onset and 21.0 ± 9.6 days in slow-onset GBS, p < 0.01). Preceding events were less commonly identified in slow-onset forms. Patients with rapid-onset GBS were more likely to have axonal variants (p < 0.05). All three groups of patients were treated in a similar way, and there were no differences in GDS score at nadir (p > 0.05) and on discharge (p > 0.05) and no differences in the duration of hospital stay.
Faster progression of GBS does not imply a poorer short-term functional outcome of the disease.
关于吉兰-巴雷综合征(GBS)的进展率与疾病结局之间的关联,数据并不多。
本研究旨在分析 GBS 的短期结局与疾病进展率之间的关系。
我们的回顾性研究纳入了 2009 年至 2014 年在 7 家三级医疗中心诊断为 GBS 的患者。根据从症状发作到最低点的疾病进展速度,患者被分为三组:快速进展型 GBS(最大 48 小时内达到最低点)、逐渐进展型(3 至 14 天内达到最低点)和缓慢进展型(15 至 28 天内达到最低点)。在最低点和出院时使用吉兰-巴雷残疾量表(GDS)评估功能残疾。
在纳入研究的 380 例患者中,24 例(6.3%)为快速进展型,274 例(72.1%)为逐渐进展型,82 例(21.6%)为缓慢进展型 GBS。更快进展型疾病的发病到住院时间更短(快速进展型为 3.0±4.1 天,逐渐进展型为 6.8±9.5 天,缓慢进展型为 21.0±9.6 天,p<0.01)。缓慢进展型中,前驱事件较不常见。快速进展型 GBS 患者更可能出现轴索性变异(p<0.05)。三组患者的治疗方式相似,在最低点(p>0.05)和出院时(p>0.05)的 GDS 评分以及住院时间均无差异。
GBS 的更快进展并不意味着疾病的短期功能结局更差。