Role of prazosin in patients with Guillain-Barré syndrome with sympathetic overactivity: A cohort study.

IF 2.8 3区医学 Q2 CLINICAL NEUROLOGY

Muscle & Nerve Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI:10.1002/mus.28236

Mritunjai Kumar, Abhishek Guin, Anu Singh, Rajni Singh, Ashutosh Tiwari

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引用次数: 0

Abstract

Introduction/aims: In Guillain-Barré syndrome (GBS), patients with dysautonomia demonstrate sympathetic overactivity (SO). This study assessed the role of prazosin (α₁-blocker) in the management of SO.

Methods: This cohort study was conducted from January 2022 to September 2023. Thirty-two GBS patients with SO received prazosin (2.5-10 mg three times a day) (prazosin group). For comparison, we included historical controls that included 33 GBS patients having SO with similar baseline characteristics, including median age and disability, who did not receive prazosin, from a GBS registry of patients admitted during February 2018-December 2021. The primary endpoint was days to resolution of SO. Secondary endpoints were daily fluctuations in the systolic (SBP) and diastolic blood pressure (DBP), duration of hospital stay, in-hospital mortality, and disability at 3 months.

Results: The median ages of both the treatment and the control groups were 36 (IQR 25-49) years and 43 (66.2%) were males. The demographic and clinical parameters were comparable. Prazosin resulted in significantly earlier normalization of SO compared to the control group (median 15 vs. 20 days; p = .01). The mean fluctuations in the SBP and DBP at 15 days were significantly lower in the prazosin group. However, the duration of hospital stay and good recovery at 3 months were comparable. Three patients developed hypotension, while two patients died (ventilator-associated pneumonia) in the prazosin group.

Discussion: This study provides new evidence supporting the role of prazosin in SO, and needs randomized trials to confirm our findings.

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哌唑嗪在伴有交感神经过度活动的格林-巴利综合征患者中的作用：一项队列研究。

导言/目的：吉兰-巴雷综合征（GBS）患者会出现交感神经过度活动（SO）。本研究评估了哌唑嗪（α1-受体阻滞剂）在治疗交感神经过度活动中的作用：这项队列研究于 2022 年 1 月至 2023 年 9 月进行。32名患有SO的GBS患者接受了哌唑嗪治疗（2.5-10毫克，一天三次）（哌唑嗪组）。为了进行比较，我们纳入了历史对照组，包括33名患有SO的GBS患者，这些患者的基线特征相似，包括中位年龄和残疾程度，但没有接受哌唑嗪治疗，这些患者来自GBS登记处，收治于2018年2月至2021年12月期间。主要终点为SO缓解天数。次要终点为收缩压（SBP）和舒张压（DBP）的每日波动、住院时间、院内死亡率和3个月时的残疾情况：治疗组和对照组的中位年龄均为 36 岁（IQR 25-49），男性 43 人（66.2%）。两组的人口统计学和临床参数相当。与对照组相比，哌唑嗪能明显提前使SO恢复正常（中位数为15天对20天；P = .01）。哌唑嗪组在15天时的SBP和DBP平均波动明显低于对照组。不过，哌唑嗪组的住院时间和 3 个月后的恢复情况相当。哌唑嗪组有三名患者出现低血压，两名患者死亡（呼吸机相关肺炎）：本研究为哌唑嗪在SO中的作用提供了新的证据，需要随机试验来证实我们的研究结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Muscle & Nerve 医学-临床神经学

CiteScore

6.40

自引率

5.90%

发文量

287

审稿时长

3-6 weeks

期刊介绍： Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.