[格林-巴利综合征患儿的临床特征及布莱顿标准的意义]
[Clinical features of children with Guillain-Barré syndrome and the significance of Brighton criteria].
作者信息
Liang Ju-Fang, Sun Rui-Di, Wang Rui-Xue, Luo Jun, Wang Heng-Dong, Jiang Jun
机构信息
Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Feb;23(2):153-157. doi: 10.7499/j.issn.1008-8830.2009175.
OBJECTIVE
To study the clinical features of children with Guillain-Barré syndrome (GBS) and the significance of Brighton criteria in childhood GBS.
METHODS
A retrospective analysis was performed on the medical data of 72 children with GBS. Brighton criteria were used for the grading of diagnostic certainty (level 1 as the highest level, and level 4 as the lowest level). A Spearman's rank correlation analysis was used to evaluate the correlation of auxiliary examinations with the level of diagnostic certainty of Brighton criteria.
RESULTS
A total of 72 children with GBS were enrolled, with a mean age of onset of (98±32) months. All children (100%, 72/72) had weakness of bilateral limbs and disappearance or reduction of tendon reflex, and limb weakness reached the highest level of severity within 4 weeks. Of all the 72 children, 68 (94%) had positive results of neural electrophysiological examination and 51 (71%) had positive results of cerebrospinal fluid (CSF) examination, and the positive rate of neural electrophysiological examination was significantly higher than that of CSF examination ( < 0.01). The median interval time from disease onset to neural electrophysiological examination was significantly shorter than from disease onset to CSF examination (11 days vs 14 days, < 0.01). Of all the 72 children, 49 (68%) met Brighton criteria level 1 and 21 (29%) met Brighton criteria level 2. Neural electrophysiological examination and CSF examination were positively correlated with the level of diagnostic certainty of Brighton criteria (=0.953 and 0.420 respectively, < 0.01).
CONCLUSIONS
Most of the children with GBS meet Brighton criteria level 1, and the positive results of CSF examination and neural electrophysiological examination play an important role in improving the level of diagnostic certainty of Brighton criteria. Neural electrophysiological examination has a higher positive rate than CSF examination in the early stage of the disease.
目的
研究吉兰-巴雷综合征（GBS）患儿的临床特征及布莱顿标准在儿童GBS中的意义。
方法
对72例GBS患儿的病历资料进行回顾性分析。采用布莱顿标准对诊断确定性进行分级（1级为最高级别，4级为最低级别）。采用Spearman等级相关分析评估辅助检查与布莱顿标准诊断确定性水平的相关性。
结果
共纳入72例GBS患儿，平均发病年龄为（98±32）个月。所有患儿（100%，72/72）均有双侧肢体无力及腱反射消失或减弱，且肢体无力在4周内达到最严重程度。72例患儿中，68例（94%）神经电生理检查结果阳性，51例（71%）脑脊液（CSF）检查结果阳性，神经电生理检查阳性率显著高于CSF检查（<0.01）。从发病到神经电生理检查的中位间隔时间显著短于从发病到CSF检查的时间（11天对14天，<0.01）。72例患儿中，49例（68%）符合布莱顿标准1级，21例（29%）符合布莱顿标准2级。神经电生理检查和CSF检查与布莱顿标准诊断确定性水平呈正相关（分别为=0.953和0.420，<0.01）。
结论
大多数GBS患儿符合布莱顿标准1级，CSF检查和神经电生理检查结果阳性对提高布莱顿标准的诊断确定性水平具有重要作用。在疾病早期，神经电生理检查的阳性率高于CSF检查。
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