摘要
目的 研究北京市和河北省格林 -巴利综合征 (GBS)的流行病学和临床特征。方法 采用强化病例监测的方法 ,于 1993～ 1994年对北京市 4个城区、2个县和河北省 3个县进行 GBS流行病学调查。结果 根据NINCDS标准 ,在调查期间确诊为 GBS者共 5 4例。 GBS农村和城市的发病率经年龄调整后分别为 0 .9/ 10万和0 .8/ 10万。发病年龄专率高峰见于 5 0～ 5 9岁。农村春夏季发病率高于秋冬季 ,二者差异具有统计学意义 (P<0 .0 5 ) ,上述指标在城市差别则不明显 (P=0 .98)。农村和城市患者分别于起病后平均在 4.3和 7.6 d无力症状达高峰 ,发病后分别于 11.8和 17.5 d开始恢复 ,12个月随访时 79.2 %患者完全恢复 ,病死率分别为 8.6 %和 5 .3%。北京两县 19例患者的电生理检查结果表明 ,17例 (89.5 % )有脱髓鞘病变 ,10例 (5 2 .6 % )同时伴不同程度的轴索损伤 ,只有 1例 (5 .3% )以轴索病变为主。 2例患者的周围神经活检结果表明 ,病变以脱髓鞘为主。结论 北京和河北GBS的流行病学和临床特征与世界其他国家和地区相仿 ,分型以脱髓鞘型
Objective To investigate epidemiological and clinical patterns of GuillainBarré syndrome (GBS) in urban and rural areas in Beijing municipality and Hebei province, China. Methods We investigated GBS incidence using a strengthened case surveillance and an active case ascertainment in 2 counties and 4 districts of Beijing municipality and 3 counties of Hebei province during 1993 to 1994. Results On the basis of the diagnostic criteria of NINCDS, 54 patients were identified. The ageadjusted incidence rates per 100 000 population for GBS were 09 in rural areas, and 08 in urban areas. A peak agespecific incidence showed in adults aged 50 to 59 years. A higher incidence appeared to occur in the spring and summer for rural residents, but not significant for urban population. In comparing course of GBS in rural and urban areas, there were differences in mean days from beginning of neurological symptom to maximal weakness(43 vs 76 days), and from symptom onset to beginning of recession (118 vs 175 days). There were preceding events in 72% patients, most frequently in respiratory infection, sensory disturbance in 709%, and respiratory assistance in 76%. The outcome was compatible with other reports; with complete recovery at 12 months in 792% and minimal residua in 208% for those alive and with casefatality rate in 74%. In addition, a followup study on electrophysiological features in 19(905%) patients from two counties of Beijing showed the demyelinating lesion (895%) over the axonal lesion (526%) of motor and/or sensory nerves. Conclusions The epidemiological and clinical characteristics of GBS were similar to that reported in other countries. Demyelinating GBS was the main pattern in present populationbased study.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2000年第2期115-119,共5页
Acta Academiae Medicinae Sinicae
