Shian W J, Chi C S
Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Aug;54(2):131-5.
Guillain-Barre syndrome (GBS) occurs at all ages, and population-based studies give it a crude average annual incidence rate ranging from 0.4 to 1.7 per 100,000 population. This retrospective study is performed for fifteen Chinese infants and children in light of the fact that GBS infrequently occurs during childhood years.
Hospital records of fifteen Chinese infants and children, i.e. eleven males and four females, with GBS were included. Their ages ranged from one to sixteen years old, with a mean average of 8.5 years. Their performances were graded on a scale from 0 to 6 according to the GBS Study Group. Their performances were graded under categories of Grades 2 (2/15), 3 (2/15), 4 (8/15) and 5 (3/15).
Seven patients (46.7%) had preceding viral illness, occurring from seven to fourteen days prior to admission, with a mean average of twelve days. In addition to weakness and areflexia, musculoskeletal pain and subjective paresthesia were the most common presentations upon admission. The later the cerebrospinal fluid (CSF) was examined, the more cases had CSF features of increased protein level with no or mild pleocytosis. Eleven patients underwent serological examinations, and seven of their tests yielded positive for Epstein-Barr virus in five and Mycoplasma pneumoniae in two. Seven patients underwent electromyography and nerve conduction velocity measurement, all exhibiting the characteristic features of demyelination. Twelve patients had supportive treatment, and three of them required mechanical ventilation. Intravenous gamma globulin was administered in two patients, and oral prednisolone was administered in one patient. It took one to six months with a mean average of 3.4 months for patients' performance returning to Grade 0. All of the patients survived without residual disability.
Some infectious pathogens could play a role in the pathogenesis of GBS. Furthermore, complete recovery may be the rule for most infants and children with GBS.
吉兰 - 巴雷综合征（GBS）可发生于各年龄段，基于人群的研究表明其粗年均发病率为每10万人0.4至1.7例。鉴于GBS在儿童期较少发生，故开展了此项针对15例中国婴幼儿及儿童的回顾性研究。
纳入15例患有GBS的中国婴幼儿及儿童的医院记录，其中男性11例，女性4例。年龄范围为1至16岁，平均年龄8.5岁。根据GBS研究组的标准，其病情表现按0至6级进行分级。病情表现分级为2级（2/15）、3级（2/15）、4级（8/15）和5级（3/15）。
7例患者（46.7%）在入院前7至14天有前驱病毒感染，平均为12天。入院时除了肌无力和腱反射消失外，肌肉骨骼疼痛和主观感觉异常是最常见的表现。脑脊液（CSF）检查时间越晚，出现蛋白水平升高且无或仅有轻度细胞增多的CSF特征的病例越多。11例患者接受了血清学检查，其中7例检测结果显示，5例爱泼斯坦 - 巴尔病毒阳性，2例肺炎支原体阳性。7例患者接受了肌电图和神经传导速度测量，均表现出脱髓鞘的特征性表现。12例患者接受了支持治疗，其中3例需要机械通气。2例患者接受了静脉注射丙种球蛋白治疗，1例患者接受了口服泼尼松龙治疗。患者病情恢复至0级需1至6个月，平均为3.4个月。所有患者均存活，无残留残疾。
某些感染性病原体可能在GBS的发病机制中起作用。此外，大多数GBS婴幼儿及儿童可能会完全康复。
