Ruiz-Sandoval Jose Luis, Salvatella-Gutiérrez Ana Paola, López-Valencia Germán, Chiquete Erwin, Ruiz-Herrera Vida, Pérez-Gómez Héctor Raúl, Adrián Miranda-García Luis, Jiménez-Ruiz Amado, Rodríguez-Hinojosa Jorge, Quintero-Reyes Ángeles, González-Jaime José de Jesús, Villaseñor Cabrera Teresita de Jesús
Department of Neurology, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara; Department of Neurosciences, Translational Neurosciences Institute, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México.
Department of Neurology, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco, México.
Neurol India. 2021 Jan-Feb;69(1):107-114. doi: 10.4103/0028-3886.310063.
Information regarding the clinical presentation and outcome of Guillain-Barré Syndrome (GBS) in adults from Latin America is limited.
To identify clinical characteristics and short-term outcome predictors in adult Mexican patients with GBS.
We included adult patients with clinical and electrophysiological data with confirmed GBS, admitted to a tertiary hospital in Western Mexico, from January 2002 to February 2011. A good outcome at hospital discharge was considered if patients had a Hughes score of 0-2 and at 3 and 6 months, a Hughes score of 0-1.
A total of 115 patients were analyzed (68% men, mean age 44 years old, range 18-84). Previous infection occurred in 63% of cases. Descendent pattern of weakness was observed in 40 (35%) patients. GBS subtypes were: acute motor axonal neuropathy in 31%, acute inflammatory demyelinating polyneuropathy in 29%, sensory axonal neuropathy (AMSAN) in 18%, and equivocal in 22%. A total of 73 (63%) patients received induction therapy: 50 (68%) received plasmapheresis and 13 (18%) received intravenous immunoglobulin (IVIG). In-hospital mortality occurred in 14 (12%) patients. Early gait complaints and emergency room admission with mild Hughes score (0-2) were predictors for a good outcome at hospital discharge (P < 0.05); meanwhile, age >75 years; dysarthria and higher Hughes score were associated with a poor outcome(P < 0.05).
Axonal pattern, motor involvement, and the descendent pattern of presentation were the main clinical GBS findings in our cohort. Higher Hughes scale scores at hospital admission were a strong predictor for a bad outcome at hospital discharge and short-term follow-up, independently of treatment type or in-hospital management. GBS in Mexico still carries considerable mortality.
关于拉丁美洲成人吉兰-巴雷综合征（GBS）临床表现及预后的信息有限。
确定成年墨西哥GBS患者的临床特征及短期预后预测因素。
纳入2002年1月至2011年2月在墨西哥西部一家三级医院住院、有临床及电生理数据且确诊为GBS的成年患者。若患者出院时Hughes评分为0 - 2分，3个月及6个月时Hughes评分为0 - 1分，则认为预后良好。
共分析115例患者（68%为男性，平均年龄44岁，范围18 - 84岁）。63%的病例有既往感染史。40例（35%）患者出现下行性肌无力模式。GBS亚型为：急性运动轴索性神经病占31%，急性炎症性脱髓鞘性多发性神经病占29%，感觉轴索性神经病（AMSAN）占18%，不典型占22%。共73例（63%）患者接受诱导治疗：50例（68%）接受血浆置换，13例（18%）接受静脉注射免疫球蛋白（IVIG）。14例（12%）患者在住院期间死亡。早期步态主诉及以轻度Hughes评分（0 - 2）入住急诊室是出院时预后良好的预测因素（P < 0.05）；同时，年龄>75岁、构音障碍及较高的Hughes评分与预后不良相关（P < 0.05）。
轴索性模式、运动受累及下行性表现模式是我们队列中GBS的主要临床特征。入院时较高的Hughes量表评分是出院时及短期随访预后不良的有力预测因素，与治疗类型或住院管理无关。墨西哥的GBS仍有相当高的死亡率。
