【摘要】：目的:通過(guò)對(duì)吉蘭-巴雷綜合征的臨床分型和預(yù)后進(jìn)行分析,探討吉蘭-巴雷綜合征各亞型臨床特點(diǎn)、預(yù)后及影響預(yù)后的相關(guān)因素。 方法:收集重慶醫(yī)科大學(xué)附屬第一醫(yī)院2006年-2013年收治的170例吉蘭-巴雷綜合征患者的臨床資料進(jìn)行分析,并根據(jù)臨床表現(xiàn)、電生理表現(xiàn)分為急性炎癥性脫髓鞘性多發(fā)神經(jīng)病(acute inflammatorydemyelinating polyneuropathy,AIDP)、急性運(yùn)動(dòng)軸索性神經(jīng)病(acutemotor axonal neuropathy,AMAN)、Miller-Fisher綜合征(Miller-Fishersyndrom,MFS)、腦神經(jīng)型(cranial nerve variants,CNV）、Bicherstaff腦干腦炎疊加吉蘭巴雷綜合征(Bickerstaff's brainstem encephalitis overlapswith Guillain-Barre syndrome,BBE-GBS)和其他組。采用χ2檢驗(yàn)分析各型GBS臨床特點(diǎn),對(duì)隨訪到的139例患者采用重復(fù)測(cè)量方差分析及多因素Logistic回歸分析進(jìn)行預(yù)后及預(yù)后相關(guān)因素的分析。 結(jié)果:AIDP組97例(57%)，AMAN組37例(22%)，MFS組12例(7%)，腦神經(jīng)組8例(5%)，BBE-GBS組8例(5%)，其他組8例（5%）。據(jù)各組間3個(gè)月及6個(gè)月HFGS評(píng)分比較各組間預(yù)后，AMAN組與BBE-GBS組之間3個(gè)月預(yù)后（F值=3.29，P=0.0704）與6個(gè)月預(yù)后（F值=1.97，P=0.1614）均無(wú)統(tǒng)計(jì)學(xué)差異；AMAN組與AIDP組3個(gè)月(F值=10.33，P=0.0014)、6個(gè)月(F值=15.26，P=0.0001)預(yù)后有統(tǒng)計(jì)學(xué)差異；MFS組（0.72±0.79）、腦神經(jīng)型（0.29±0.49）6個(gè)月預(yù)后均良好。Logistic回歸分析顯示病情達(dá)峰時(shí)HFGS評(píng)分≥3分[P0.0001，OR=6.650、95%CI(2.865,15.023)],自主神經(jīng)功能障礙[P=0.0435， OR=2.820、95%CI(1.031,7.715)]與預(yù)后不良(HFGS評(píng)分1分)有關(guān)。 結(jié)論:AIDP為GBS主要亞型；AMAN組和BBE-GBS組3個(gè)月與6個(gè)月預(yù)后均較AIDP組差；腦神經(jīng)型GBS與MFS預(yù)后良好；重型患者、自主神經(jīng)功能障礙為GBS預(yù)后不良預(yù)測(cè)因素。
[Abstract]:Objective: to study the clinical characteristics, prognosis and related factors of Guillain-Barre syndrome (GBS) by analyzing the clinical classification and prognosis of Guillain-Barre syndrome. Methods: the clinical data of 170 patients with Guillain-Barre syndrome admitted from 2006 to 2013 in the first affiliated Hospital of Chongqing Medical University were collected and analyzed. The electrophysiological manifestations were as follows: acute inflammatory demyelinating multiple neuropathy (acute inflammatorydemyelinating polyneuropathy,AIDP), acute motor axis neuropathy (acutemotor axonal neuropathy,AMAN), Miller-Fisher syndrome (Miller-Fishersyndrom,MFS), cerebral (cranial nerve variants,CNV. Bicherstaff brainstem encephalitis superimposed (Bickerstaff's brainstem encephalitis overlapswith Guillain-Barre syndrome,BBE-GBS and other groups. The clinical features of various types of GBS were analyzed by 蠂 2 test. The prognostic and prognostic factors were analyzed by repeated measurement analysis of variance and multivariate Logistic regression analysis. Results: 97 cases (57%), AMAN, 37 cases (22%), MFS, 12 cases, 7%) in AIDP group, 8 cases (5%) in brain nerve group, 8 cases (5%) in BBE-GBS group, 8 cases (5%) in other groups. According to the HFGS scores of 3 and 6 months, there was no significant difference in the prognosis between the AMAN group and the BBE-GBS group in 3 months (F = 3.29 P0. 0704) and 6 months (F = 1. 97 P0. 1614). The prognosis of AMAN group was significantly different from that of AIDP group at 3 months (F = 10. 33) and 6 months (F = 15. 26 P0. 0001). The prognosis of MFS group (0.72 鹵0.79) and cerebral nerve type (0.29 鹵0.49) was good at 6 months. Logistic regression analysis showed that the HFGS score was 鈮，

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