焦劲松;矫毓娟;王国相;金淼;汪仁斌;段晓慧;王丽;

• 1:中日友好医院神经内科
• 2:中日友好医院神经内科
• 3:中日友好医院神经内科
• 4:中日友好医院神经内科

摘要(Abstract)：

目的观察合并应用激素冲击治疗对血浆置换(PE)治疗吉兰-巴雷综合征(GBS)患者疗效的影响。方法对发病后2周内入院的GBS患者采用分组对照观察,其中甲基强地松龙(MP)冲击组7例,PE治疗组12例,PE合并MP冲击组11例。治疗4周后比较不同治疗方案对GBS的疗效。结果入院时MP冲击组、PE治疗组和PE合并MP冲击组Hughes评分分别为(3.1±0.7)、(3.4±0.8)和(3.5±1.1),差异无统计学意义(P>0.05)。治疗4周后比较各组评分改善情况结果表明,PE治疗组及PE合并MP冲击组均较MP冲击组病情改善明显(均P<0.05);而PE治疗组和PE合并MP冲击组的病情改善差异均无统计学意义(P>0.05)。另外,PE治疗组和PE合并MP冲击组在治疗4周时Hughes评分进步1分以上的比例分别为91.7%和81.8%,治疗4周后两组患者可独立步行5 m以上的比例分别为9/12例(75%)和9/11例(81.8%),均无统计学意义(P>0.05)。结论PE治疗和PE合并MP冲击对GBS疗效均明显优于单纯MP冲击治疗。至于MP冲击治疗对PE治疗GBS的短期疗效影响,尚有待于扩大样本进一步观察。

关键词(KeyWords)： 吉兰-巴雷综合征;血浆置换;激素冲击;治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 焦劲松;矫毓娟;王国相;金淼;汪仁斌;段晓慧;王丽;

Email:

参考文献(References)：

• [1]Hughes RA,Wijdicks EF,Barohn R,et al.Practiceparameter:immunotherapy for Guillain-Barre syn-drome:report of the Quality Standards Subcommitteeof the American Academy of Neurology[J].Neurology,2003,61(6):736-740.
• [2]Fergusson D,Hutton B,Sharma M,et al.Use ofintravenous immunoglobulin for treatment of neuro-logic conditions:a systematic review[J].Transfu-sion,2005,45(10):1640-1657.
• [3]Asbury AK,Cornblath DR.Assessment of currentdiagnostic criteria for Guillain-Barre syndrome[J].Ann Neurol,1990,27(suppl):s21-s24.
• [4]Hughes RA,Newsom-Davis JM,Perkin GD,et al.Controled trial of prednisolone in acute polyneuroph-athy[J].Lancet,1978,2:750.
• [5]Fletcher DD,Lawn ND,Wolter TD,et al.Long-term outcome in patients with Guillain-Barresyndrome requiring mechanical ventilation[J].Neu-rology,2000,54(12):2311-2315.
• [6]Hadden RD,Hughes RA.Management of inflamma-tory neuropathies[J].J Neurol Neurosurg Psychiatry,2003,74(suppl 2):ii9-ii14.
• [7]van Koningsveld R,Schmitz PI,Meche FG,et al.Effect of methylprednisolone when added to standardtreatment with intravenous immunoglobulin for Guil-lain-Barre syndrome:randomised trial[J].Lancet,2004,363(9404):192-196.
• [8]Dada MA,Kaplan AA.Plasmapheresis treatment inGuillain-Barre syndrome:potential benefit over IVIgin patients with axonal involvement[J].Ther ApherDial,2004,8(5):409-412.
• [9]Lyu RK,Chen WH,Hsieh ST.Plasma exchange ver-sus double filtration plasmapheresis in the treatment ofGuillain-Barre syndrome[J].Ther Apher,2002,6(2):163-166.
• [10]The French Cooperative Group on Plasma Exchange inGuillain-Barre Syndrome.Appropriate number ofplasma exchanges in Guillain-Barre syndrome[J].Ann Neurol,1997,41(3):298-306.