摘要
目的评估吉兰-巴雷综合征(GBS)患者的临床特征、血清血蛋白、脑脊液及电生理改变对急性期病情严重程度的预测价值。方法回顾性分析2016年10月至2022年1月于昆明医科大学第二附属医院神经内科住院首次发病诊断为GBS的患者51例,评价患者疾病高峰时Hughes评分,将患者分为轻型和重型两组,收集临床资料、血清血蛋白、脑脊液及电生理等资料。采用Logistic多因素回归分析,将所获得的独立预测因子绘制受试者工作特征曲线(ROC)。结果轻、重型组中,颅神经受累、自主神经受累差异有统计学意义(P<0.05)。重型组患者血清白蛋白低于轻型患者(P<0.05),脑脊液蛋白、脑脊液IgA、IgM重型患者明显高于轻型患者(P<0.05)。电生理检查中,两组运动神经传导速度和复合肌肉动作电位波幅差异有统计学意义(P<0.05)。多因素Logistic回归分析显示血清白蛋白(OR值为0.818,95%CI为0.669~0.999,P=0.049)、脑脊液蛋白(OR值为4.174,95%CI为1.066~16.345,P=0.040)为GBS患者病情严重程度的独立预测因素。以血清白蛋白、脑脊液蛋白为检验变量,描绘ROC曲线,两者曲线下面积分别为0.722和0.671。结论血清白蛋白与脑脊液蛋白为GBS患者病情严重程度的独立预测因素,可以预测GBS患者急性期病情严重程度。
Objective To evaluate the predictive value of clinical features,serum proteins,cerebrospinal fluid,and electrophysiological changes in patients with Guillain-Barrésyndrome(GBS),of the severity of GBS in the acute phase.Methods A retrospective analysis was conducted on 51 patients admitted to the Department of Neurology of the Second Affiliated Hospital of Kunming Medical University from October 2016 to January 2022 who were diagnosed with GBS for the first time.Enrolled patients were evaluated and divided into mild group and severe group based on the Hughes disability score of patients at the peak of the disease,and clinical data,serum proteins,cerebrospinal fluid and electrophysiological data were collected.Using logistic multivariate regression analysis,the obtained independent predictors were plotted as receiver operating curve(ROC).Results There were significant differences for cranial nerve involvement and autonomic nerve involvement between the mild and severe groups(P<0.05).Serum albumin in the severe group was lower than that in the mild group(P<0.05),and cerebrospinal fluid protein,cerebrospinal fluid IgA and IgM in the severe group were significantly higher than those in the mild group(P<0.05).In electrophysiological examination,there were statistically significant differences in motor nerve conduction velocity and complex muscle action potential amplitude between the two groups(P<0.05).Multivariate logistic regression analysis showed that serum albumin level(OR value:0.818,95%CI:0.669-0.999,P=0.049)and cerebrospinal fluid protein(OR value:4.174,95%CI:1.066-16.345,P=0.040)were independent predictive factors for severity in GBS.Serum albumin and cerebrospinal fluid protein were used as test variables to depict ROC curves,and the area under the curve was 0.722 and 0.671 respectively.Conclusion Serum albumin and cerebrospinal fluid protein are independent predictive factors for the severity of GBS and can predict the severity of acute disease in GBS.
作者
何晶
熊静
贾文姬
李馨蕊
许梦圆
He Jing;Xiong Jing;Jia Wenji;Li Xinrui;Xu Mengyuan(Department of Neurology,the Second Affiliated Hospital of Kunming Medical University,Kunming City,Yunnan Province,650031,China)
出处
《现代电生理学杂志》
2023年第2期67-73,共7页
Journal of Modern Electrophysiology
基金
云南省卫生和计划生育委员会医学学科带头人培养计划(D-2017028)。
关键词
吉兰-巴雷综合征
血清白蛋白
电生理学
预测
脑脊液
Guillain-Barrésyndrome
Serum albumin
Electrophysiology
Forecasting
Cerebrospinal fluid
