Risk Factors On Patients With Severe Guillain-Barre Syndrome And A Preliminary Result Of Treatment Of Guillain-Barre Syndrome With Immunoadsorption

Part one Risk factors on patients with severe Guillain-Barre syndromeObjective:To explore the factors ralating to the severity of Guillain-Barre syndrome and to find the risk factors in early clinical presentations and laboratory investigations as to guiding the early management of GBS.Methods:All 113 cases of patients with GBS admitted from 1996-2007 were collected,and divided into two groups based on the international criteria for different severity of GBS.Severily affected patients and ventilated patients were divided in this study.Characteristics of each group in early clinical presentation and laboratory investigation were analyzed in univariate conditional Logistic model in order to find out the risk factors.Result:In all 113 patients studied,41 were having mild GBS;72 were severe GBS.Early clinical presetations and laboratory investigations were analyzed in univariate conditional 72 severe GBS(i.e.in need of mechanical ventilation during the course).The ptients with dysfunction of autonomic nervous function or other diseases were more likely to become severe GBS. Having dysfunction of autonomic nervous function or with other diseases and immunoglobulin IgG anomaly might be risk factors for the severity of GBS.Conclusion:Having dysfunction of autonomic nervous function or with other diseases and immunoglobulin IgG anomaly might be valuable risk factors for the severity of GBS.Part two A preliminary result of treatment of Guillain-Barre syndrome with immunoadsorptionObjective:To investigate the clinical efficacy of protein A immunoadsorption(IA)treatment in patients with acute Guillain-Barre syndrome.Methods:Two cases of patients with acute Guillain-Barre syndrome were collected.We study the changes of serum IgG and lymphocyte subsets of peripheral blood after one session of IA.Result:In two patients this treatment were associated with levels of IgG decreased markedly and rapid clinical improvement in two patients.The percentage of CD8+is lower.Ratio of CD4+/CD8+ increased.Nerve conduction velocities were significantly increased.Conclusion:IA is effective and safe for GBS,but the long-term effect should be followed up.