格林-巴利综合征恢复期的自主神经功能障碍自我报告。

Self-reported autonomic dysfunction in a recovery phase of Guillain-Barré syndrome.

机构信息

Neurology Clinic, Clinical Center of Serbia, Dr Subotic Street 6, 11 000 Belgrade, Serbia.

Neurology Clinic, Clinical Center of Serbia, Dr Subotic Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotic Street 8, 11 000 Belgrade, Serbia.

出版信息

Clin Neurol Neurosurg. 2021 Feb;201:106427. doi: 10.1016/j.clineuro.2020.106427. Epub 2020 Dec 10.

DOI:10.1016/j.clineuro.2020.106427

PMID:33360355

Abstract

OBJECTIVE

Autonomic dysfunction occurs in approximately two-thirds of Guillain-Barré syndrome (GBS) patients in the acute phase of the disease. Although improving over time, subclinical autonomic involvement may be present for 3-8 years after the GBS episode. The aim of this study was to determine the frequency of self-reported autonomic disorders in GBS patients three and six months after disease onset compared to healthy controls (HCs).

METHODS

Our study included adult patients diagnosed with GBS from May 2017 until May 2018 in seven healthcare centers (67.6 % with demyelinating and 13.6 % with axonal syubtype). Functional disability was assessed by the Guillain-Barré syndrome disability scale (GDS). Each subject filled in the Serbian version of the SCOPA-Aut questionnaire. Using GDS and SCOPA-Aut, patients were tested at month 3 (M3) (n = 71) and month 6 (M6) (n = 70) from symptom onset.

RESULTS

Dysautonomia was more common in patients with GBS compared to HCs at M3 (p < 0.01), while there was no difference at M6 (p > 0.05). Among autonomic disorders, constipation, complications to pass stool, and orthostatic hypotension were the most frequently reported. Patients with axonal variants had worse total SCOPA-Aut scores at M3 in comparison to AIDP patients (11.7 ± 10.1 vs. 6.1 ± 5.1, p < 0.05). GDS score correlated with the total SCOPA-Aut score.

CONCLUSION

Autonomic symptoms are common in GBS patients during the recovery phase. They are more pronounced in patients with axonal forms of GBS and those with a higher degree of functional disability.

摘要

目的

自主神经功能障碍发生在大约三分之二的吉兰-巴雷综合征（GBS）患者的疾病急性期。尽管随着时间的推移而改善，但亚临床自主神经受累可能在 GBS 发作后 3-8 年存在。本研究的目的是确定与健康对照组（HC）相比，GBS 患者在疾病发作后 3 个月和 6 个月时自主神经障碍的自我报告频率。

方法

我们的研究包括 2017 年 5 月至 2018 年 5 月在七个医疗中心诊断为 GBS 的成年患者（67.6%为脱髓鞘型，13.6%为轴突亚型）。功能障碍通过吉兰-巴雷综合征残疾量表（GDS）评估。每位患者填写塞尔维亚语版 SCOPA-Aut 问卷。使用 GDS 和 SCOPA-Aut，患者在发病后 3 个月（M3）（n=71）和 6 个月（M6）（n=70）进行测试。

结果

与 HCs 相比，在 M3 时，GBS 患者的自主神经功能障碍更为常见（p<0.01），而在 M6 时则无差异（p>0.05）。在自主神经障碍中，便秘、排便困难和体位性低血压是最常报告的。与 AIDP 患者相比，轴突变异型患者在 M3 时的总 SCOPA-Aut 评分更差（11.7±10.1 vs.6.1±5.1，p<0.05）。GDS 评分与总 SCOPA-Aut 评分相关。