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吉兰-巴雷综合征患者乙肝核心抗体与机械通气关系的临床研究

Clinical study of the relationship between hepatitis B core antibody and mechanical ventilation in patients with Guillain-Barré syndrome.

作者信息

Zhang Wei, Yao Qian, Wang Yuqiao, Yin Junxiong, Yang Xinxin

机构信息

Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Front Neurol. 2025 Feb 24;16:1530286. doi: 10.3389/fneur.2025.1530286. eCollection 2025.

Abstract

INTRODUCTION

The aim of this study was to investigate the association between hepatitis B core antibody (HBcAb) positivity and the need of mechanical ventilation (MV) in patients with Guillain-Barré syndrome (GBS).

METHODS

We retrospectively analyzed the clinical data of 159 patients who were diagnosed with GBS between December 2014 and April 2023 in the Affiliated Hospital of Xuzhou Medical University. Patients were categorized into two groups according to the need for MV. Variables that were significantly different between the two groups in univariate analysis were analyzed through multivariate logistic regression models.

RESULTS

The final study population included 159 patients, 28 (17.6%) of whom need MV. In univariate analysis, Medical Research council sum score (MRC) on admission ( < 0.001), bulbar paralysis ( < 0.001), autonomic dysfunction ( < 0.001), HBcAb ( = 0.009), neutrophil/lymphocyte ratio (NLR) ( < 0.001), and Serum albumin ( = 0.016) were associated with MV. Multivariate logistic regression analysis showed lower MRC on admission (OR = 0.946, 95%CI: 0.908-0.985,  = 0.008), bulbar paralysis (OR = 3.726, 95%CI: 1.118-12.421,  = 0.032), autonomic dysfunction (OR = 3.804, 95%CI: 1.058-13.679,  = 0.041), HBcAb positivity (OR = 6.154, 95%CI: 1.253-30.229,  = 0.025), and higher NLR (OR = 1.214, 95%CI: 1.039-1.417,  = 0.014) were the risk factors for the need of MV in patients with GBS.

CONCLUSION

HBcAb positivity increased the risk of MV in patients with GBS. Lower MRC on admission, bulbar paralysis, autonomic dysfunction, and higher NLR were the risk factors for the need for MV.

摘要

引言

本研究旨在调查吉兰-巴雷综合征(GBS)患者中乙肝核心抗体(HBcAb)阳性与机械通气(MV)需求之间的关联。

方法

我们回顾性分析了2014年12月至2023年4月在徐州医科大学附属医院被诊断为GBS的159例患者的临床资料。根据是否需要MV将患者分为两组。对单因素分析中两组间有显著差异的变量进行多因素逻辑回归模型分析。

结果

最终研究人群包括159例患者,其中28例(17.6%)需要MV。在单因素分析中,入院时医学研究委员会总分(MRC)(<0.001)、延髓麻痹(<0.001)、自主神经功能障碍(<0.001)、HBcAb(=0.009)、中性粒细胞/淋巴细胞比值(NLR)(<0.001)和血清白蛋白(=0.016)与MV相关。多因素逻辑回归分析显示,入院时较低的MRC(OR = 0.946,95%CI:0.908 - 0.985,= 0.008)、延髓麻痹(OR = 3.726,95%CI:1.118 - 12.421,= 0.032)、自主神经功能障碍(OR = 3.804,95%CI:1.058 - 13.679,= 0.041)、HBcAb阳性(OR = 6.154,95%CI:1.253 - 30.229,= 0.025)和较高的NLR(OR = 1.214,95%CI:1.039 - 1.417,= 0.014)是GBS患者需要MV的危险因素。

结论

HBcAb阳性增加了GBS患者MV的风险。入院时较低的MRC、延髓麻痹、自主神经功能障碍和较高的NLR是需要MV的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4126/11891066/c0a56f280fbd/fneur-16-1530286-g001.jpg

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