格林-巴利综合征变异型的临床表现和治疗效果:病例系列

Yashfeen M., Mugundhan K.
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摘要

吉兰-巴雷综合征(Guillain-Barré syndrome,GBS)是一种自身免疫性多发性神经病,是一种急性、典型的重症和暴发性疾病。吉兰-巴雷综合征的发病率为每 10 万人年 0.81-1.89 例(中位数为 1.11 例),男性略高于女性。70%的患者会在呼吸道感染或腹泻(尤其是空肠弯曲菌)后 1-4 周内患上这种急性弛缓性麻痹。GBS 有多种亚型,其中以急性炎症性脱髓鞘性多发性神经病(AIDP)最为常见。此外,还有两种 "轴索 "亚型:急性运动性轴索神经病(AMAN)和急性运动感觉性轴索神经病(AMSAN),这两种病在临床上都很严重。眼球震颤、共济失调和肢体瘫痪是与抗 GQ1b 抗体相关的另一种亚型,称为米勒-费舍尔综合征(MFS)。患者的病史以及神经学、电生理学和脑脊液检查可用于诊断 GBS。静脉注射免疫球蛋白(IVIG)和血浆置换是有效的治疗方法;然而,由于 25% 的患者最终需要机械通气,20% 的患者无法行走,2-5% 的患者可能会复发,因此需要更新的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical spectrum and treatment outcomes in variants of Guillain-Barré syndrome: a case series
Guillain-Barré syndrome (GBS) is an autoimmune polyradiculoneuropathy that is acute, typically severe, and fulminant. GBS has an incidence of 0.81-1.89 (median 1.11) per 100,000 person-years, and men are slightly more susceptible to GBS than females. 70% of individuals acquire this acute flaccid paralysis condition within 1-4 weeks following a respiratory infection or diarrhoea (especially Campylobacter jejuni). There are several identified subtypes of GBS, with acute inflammatory demyelinating polyneuropathy (AIDP) being the most prevalent. Additionally, there are two "axonal" subtypes: acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN), both of which are clinically severe. The clinical trial of ophthalmoplegia, ataxia, and areflexia characterizes a different subtype called Miller Fisher syndrome (MFS) linked to anti-GQ1b antibodies. The patient's medical history, along with neurological, electrophysiological, and cerebrospinal fluid tests, are used to diagnose GBS. Intravenous immunoglobulin (IVIG) and plasma exchange are effective treatments; however, newer approaches are required because 25% of patients eventually need mechanical ventilation, 20% are unable to walk, and 2-5% of patients may experience relapses.
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