Bano Safia, Nawaz Ahmad, Nasim Aqsa, Numan Ahsan, Zahid Muhammad
Department of Neurology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.
Department of Radiology, Doctor Hospital and Medical Centre, Lahore, Pakistan.
J Coll Physicians Surg Pak. 2024 Feb;34(2):187-192. doi: 10.29271/jcpsp.2024.02.187.
To evaluate the correlation of cerebrospinal fluid total protein and serum neutrophil-to-lymphocyte ratio with the clinical outcomes and the various clinical and electrophysiological variants of Guillain-Barre syndrome.
Cross-sectional study. Place and Duration of the Study: Department of Neurology, Mayo Hospital and King Edward Medical University, Lahore, Pakistan, from November 2022 to April 2023.
Fourty-six Guillain-Barre syndrome patients, aged 12-70 years, were included in the study diagnosed by using the Brighton's criteria. Functional disability and respiratory insufficiency were assessed by using the modified Hughes disability score and the Erasmus Guillain-Barre syndrome respiratory insufficiency score, respectively. Serum neutrophil-to-lymphocyte ratio and cerebrospinal fluid total protein were calculated for each patient at the time of admission.
Axonal variants had a higher mean neutrophil-to-lymphocyte ratio (5.29 ± 4.38) than demyelinating variants (4.71 ± 3.4) and Miller-Fischer syndrome (3 ± 2.828). This ratio was positively correlated with the modified Hughes's disability score (r = 0.790, p = 0.001) and the Erasmus Guillain-Barre syndrome respiratory insufficiency score (r = 0.936, p = 0.002). Mean cerebrospinal fluid total protein was higher for demyelinating (218 ± 136 mg/dl) than axonal variants (86 ± 56 mg/dl) and Miller-Fischer syndrome (34 ± 21 mg/dl). However, higher modified Hughes disability score (4-6) (r = 0.020, p = 0.117) and a high Erasmus Guillain-Barre syndrome respiratory insufficiency score (5-7) (r = 0.115, p = 0.302) did not significantly affect mean cerebrospinal fluid total proteins.
Serum neutrophil-to-lymphocyte ratio can be regarded as a reliable biomarker to assess disease severity and clinical outcome in Guillain-Barre syndrome. Cerebrospinal fluid total protein is a poor predictor of the prognosis and severity of Guillain-Barre syndrome.
Guillain-Barre syndrome (GBS), Clinical outcome, Cerebrospinal fluid total protein (CSF-TP), Neutrophil-to-lymphocytic ratio (NLR), Prognostic biomarker.
评估脑脊液总蛋白和血清中性粒细胞与淋巴细胞比值与吉兰-巴雷综合征的临床结局以及各种临床和电生理变异之间的相关性。
横断面研究。研究地点和时间：2022年11月至2023年4月，巴基斯坦拉合尔梅奥医院和爱德华国王医科大学神经病学系。
纳入46例年龄在12至70岁之间的吉兰-巴雷综合征患者，采用布莱顿标准进行诊断。分别使用改良休斯残疾评分和伊拉斯谟吉兰-巴雷综合征呼吸功能不全评分评估功能残疾和呼吸功能不全。在入院时计算每位患者的血清中性粒细胞与淋巴细胞比值和脑脊液总蛋白。
轴索性变异型的平均中性粒细胞与淋巴细胞比值（5.29±4.38）高于脱髓鞘性变异型（4.71±3.4）和米勒-费希尔综合征（3±2.828）。该比值与改良休斯残疾评分（r = 0.790，p = 0.001）和伊拉斯谟吉兰-巴雷综合征呼吸功能不全评分（r = 0.936，p = 0.002）呈正相关。脱髓鞘性变异型的平均脑脊液总蛋白（218±136mg/dl）高于轴索性变异型（86±56mg/dl）和米勒-费希尔综合征（34±21mg/dl）。然而，较高的改良休斯残疾评分（4 - 6）（r = 0.020，p = 0.117）和较高的伊拉斯谟吉兰-巴雷综合征呼吸功能不全评分（5 - 7）（r = 0.115，p = 0.302）对平均脑脊液总蛋白没有显著影响。
血清中性粒细胞与淋巴细胞比值可被视为评估吉兰-巴雷综合征疾病严重程度和临床结局的可靠生物标志物。脑脊液总蛋白对吉兰-巴雷综合征的预后和严重程度预测能力较差。
吉兰-巴雷综合征（GBS）；临床结局；脑脊液总蛋白（CSF-TP）；中性粒细胞与淋巴细胞比值（NLR）；预后生物标志物
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