Servicio de Neurología, Consorci Hospitalari de Vic, Vic, Barcelona, Spain.
Servicio de Epidemiología Clínica e Investigación, Consorci Hospitalari de Vic, Vic, Barcelona, Spain.
Neurologia (Engl Ed). 2021 Sep;36(7):525-530. doi: 10.1016/j.nrleng.2018.03.020. Epub 2020 May 23.
According to most studies, the incidence of Guillain-Barré syndrome increases with age, with a peak incidence occurring between 70 and 80 years of age. The objective of this study is to describe the incidence (overall and by sex and age group) and clinical characteristics of Guillain-Barré syndrome in Osona (Barcelona, Spain).
We performed a retrospective, descriptive, population-based study covering the period 2003 to 2016.
The global incidence of Guillain-Barré syndrome is 2.07 cases per 100000 person-years. Incidence increases with age, except for small peaks during childhood and between 40 and 50 years, and reaches a maximum of 6.26 cases per 100000 person-years above the age of 80. The incidences of the different variants were: AIDP, 72.1%; AMAN, 16.3%; ANSAN, 4.7%; and Miller Fisher syndrome, 4.7%. A total of 41.9% of patients had a history of respiratory tract infections, and 20.9% had a history of gastrointestinal infections. Protein in the cerebrospinal fluid was found in 76.7%. EMG findings suggested demyelination in 73.7% of the patients and axonal degeneration in 26.3%. A total of 20.9% of patients needed ventilatory support. Six-month mortality was 9.3%. Variables associated with worse prognosis were age over 80 years, delay in admission, previous gastrointestinal infection, and AMAN variant.
The incidence observed in our study is in the upper range of estimated incidence rates reported in European and North American studies. The syndrome may be underdiagnosed in elderly patients; physicians must be vigilant to the possibility of the disease, which is associated with a high mortality rate if it is not treated early.
根据大多数研究，吉兰-巴雷综合征的发病率随年龄增长而增加，发病高峰出现在 70 至 80 岁之间。本研究的目的是描述在西班牙巴塞罗那奥索尼（Osona）发生的吉兰-巴雷综合征的发病率（总体及按性别和年龄组）和临床特征。
我们进行了一项回顾性、描述性、基于人群的研究，涵盖了 2003 年至 2016 年期间。
吉兰-巴雷综合征的全球发病率为每 10 万人 2.07 例。发病率随年龄增长而增加，但在儿童时期和 40 至 50 岁之间出现小高峰，80 岁以上人群的发病率最高，达到每 10 万人 6.26 例。不同变异型的发病率分别为：急性炎症性脱髓鞘性多发性神经病（AIDP）72.1%；急性运动轴索性神经病（AMAN）16.3%；急性运动感觉轴索性神经病（ANSAN）4.7%；米勒费舍尔综合征（Miller Fisher syndrome）4.7%。41.9%的患者有呼吸道感染史，20.9%有胃肠道感染史。76.7%的患者脑脊液中存在蛋白。肌电图检查结果显示 73.7%的患者存在脱髓鞘，26.3%的患者存在轴索变性。共有 20.9%的患者需要通气支持。6 个月死亡率为 9.3%。与预后较差相关的变量包括年龄超过 80 岁、住院延迟、先前的胃肠道感染和 AMAN 变异型。
我们研究中观察到的发病率处于欧洲和北美研究报告的估计发病率的较高范围。该综合征在老年患者中可能被漏诊；医生必须警惕这种疾病的可能性，如果不早期治疗，死亡率很高。
