格林-巴利综合征的临床特征、实验室检查结果和功能结果:孟加拉国 50 例病例的经验

Md Rashedul Islam, Tanbin Rahman, R. Habib, Aminur Rahman, N. B. Bhowmik, Md Amirul Haque
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摘要

背景:吉兰-巴雷综合征(Guillain-Barré Syndrome,GBS)是一种急性免疫介导的多发性神经病,是急性弛缓性麻痹最常见的病因之一。GBS 的临床表型和功能结果多种多样:本研究旨在评估孟加拉国一家三级医疗中心收治的 GBS 患者的临床特征和预后:这项前瞻性队列研究于 2016 年 1 月至 2020 年 6 月在孟加拉国达卡 BIRDEM 综合医院神经内科进行。研究对象包括年龄大于或等于 18 岁、符合 GBS 诊断标准的成年患者:大多数患者为男性(64.0%)。24 名患者(48.0%)入院时最常见的症状是上行性麻痹。研究对象的平均年龄为 31.5 岁,从 19 岁到 60 岁不等。24名患者(48.0%)入院时的GBS残疾评分为4分。相反,39 例(78.0%)患者的 GBS 残疾评分在最低时为 4 分。14例(28.0%)患者出现腹泻,9例(18.0%)患者出现呼吸道感染。56% 的患者 GBS 残疾评分为 0 至 2 分,38.0% 为 3 至 4 分,只有 6.0% 为 5 至 6 分。在本研究中,大多数患者(62.0%)的诊断符合布莱顿标准 1 级。 根据神经传导研究,GBS 变异为 AIDP(54.0%)、AMAN(34.0%)和 AMSAN(12.0%)。72.0%的病例脑脊液蛋白升高。如果考虑到 GBS 残疾评分,被诊断为 AMAN 和 AMSAN 的患者 3 个月后的预后比 AIDP 组患者差:结论:在本研究中,GBS 多见于年轻男性群体,大多数患者未发现前驱事件。在我们的研究中,AIDP 是最常见的变异,预后相对较好,其次是 AMAN。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Characteristics, Laboratory Findings and Functional Outcomes of Guillain-Barre Syndrome: Experience of 50 Cases in Bangladesh
Background: Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy which is one of the most frequent causes of acute flaccid paralysis. GBS has diverse clinical phenotype and functional outcome. Objective: The purpose of the present study was to evaluate clinical profiles and outcomes of GBS patients admitted in a tertiary care centre of Bangladesh. Methodology: This prospective cohort study was conducted in the Department of Neurology from January 2016 to June, 2020 in BIRDEM General Hospital, Dhaka, Bangladesh. Adult patients more than or equal to 18 years of age who had fulfilled the diagnostic criteria of GBS were included in the study. Results: Majority of the patients were male (64.0%). The most common presenting symptom at entry was ascending paralysis that occurred in 24 patients (48.0%). Mean age of the study population is 31.5 years ranging from 19 to 60 years. Twenty four (48.0%) patients had GBS disability score of 4 at entry. On the contrary, 39(78.0%) cases had GBS disability score of 4 at nadir. Diarrhea was reported in 14(28.0%) cases and respiratory tract infection was reported in 9(18.0%) cases. Fifty six percents of patients had GBS disability score of 0 to 2, 38.0% had 3 to 4 and only 6.0% had 5 to 6. Majority of the patients had Brighton criteria level 1 certainty of diagnosis (62.0%) in this study.  GBS variants according to nerve conduction studies were AIDP (54.0%), AMAN (34.0% and AMSAN (12.0%). CSF protein was raised in 72.0% cases. Patients diagnosed with AMAN and AMSAN had worse outcome after 3 months in comparison to AIDP group of patients if we consider GBS disability score. Conclusion: GBS has been found more in younger and male population group in this present study where Antecedent events were not found in majority of the patients. AIDP was the commonest variant in our study with comparatively good outcome followed by AMAN. Journal of National Institute of Neurosciences Bangladesh, July 2023;9(2):108-115
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