Analysis Of The Correlation Between Abnormal Glucose Metabolism And Guillain-Barre Syndrome

Objective:Guillain-Barre syndrome(GBS)is a type of immune-mediated acute inflammatory peripheral neuropathy.Abnormal glucose metabolism can easily cause microvascular degeneration and chronic inflammation,affecting the clinical symptoms and short-term prognosis of GBS.In this paper,the correlation between GBS and abnormal glucose metabolism is studied to investigate whether abnormal glucose metabolism is an independent risk factor for poor short-term prognosis of GBS.Methods:Use retrospective research methods.All hospitalized patients diagnosed with GBS in the Department of Neurology of the First Affiliated Hospital of Nanchang University from 2012 to 2017 were selected as the study subjects.Ninety-six subjects were included in the study.All cases were diagnosed in accordance with the criteria for the diagnosis of Guillain-Barré syndrome by the Chinese Medical Association in 2010..In this study,basic data such as gender and age(age >50 years)of all patients were collected.All patients were also collected from the onset to the time of admission,from the onset to the time of discharge,detailed diagnosis,history of precursor infection,past history,admission,The condition of peak muscle strength at the time of peak illness and at the time of discharge(using MRC scales 0 to 5 muscle strength test methods for evaluation),whether complications of medulla oblongata and respiratory muscle paralysis,whole blood biochemical test results(such as serum sodium,Fasting and OGTT venous blood glucose levels),the main treatment given during hospitalization,and the prognosis of the disease(good prognosis and poor prognosis were assessed using the Hughe scale).Exclusion criteria were established.After exclusion criteria were excluded,a total of 73 cases met the criteria for enrollment in this study,and eligible cases were collated and analyzed.Result:1 General clinical data of GBS patients:Seventy-three GBS patients met the criteria for enrollment in this study,44 males(69.8%)and 29 females(40.2%);aged 19-82 years,with an average age of 47 years;40 of them were senior patients(54.8 %),33 cases(45.2%)were non-elderly patients.The average time from onset to admission was 7.43±3.72 days.In this study,55 patients(75.3%)had normal glucose metabolism and 18 patients(24.7%)had abnormal glucose metabolism.There were 16 patients(29.1%)with a history of precursor infection.Among the 73 GBS patients,38 cases(52.1%),15 cases(17.8%),and 22 cases(30.1%)of mild,moderate,and severe GBS patients with peak MRC scores were in peak condition.There were 18 patients(24.7%)with hyponatremia;4 patients(5.5%)with medulla oblongata;11 patients(15.1%)with tracheal intubation and mechanical ventilation due to respiratory muscle paralysis;patients with secondary pulmonary infection 14 cases(32.9%).All of the patients excluded from the exclusion criteria underwent lumbar puncture and cerebrospinal fluid examination.Of the 73 patients,62 patients underwent neurophysiological examination after admission,and 11 patients failed due to various reasons.At the time of discharge,63(86.3%)patients had a good prognosis and 10(13.7%)had a poor prognosis.2 Comparison of basic clinical features of abnormal glucose metabolism in GBS patients:The average age of normal glucose metabolism group was 44.3 years,and the average age of abnormal glucose metabolism group was 57.7 years.There was a statistically significant difference between the two groups(P<0.05).However,the incidence of normal glucose metabolism was compared between the two groups of elderly patients.There was no statistically significant difference between the group’s incidence rate and the abnormal glucose metabolism group;similarly,male patients,onset-to-admission time,onset-to-discharge time,precursor infection,bulbar paralysis,respiratory muscle paralysis,and lung infection incidence were also statistically significant.There was no significant difference;however,there was a statistically significant difference in the incidence of MRC scores between the normal glucose metabolism group and the abnormal glucose metabolism group(P<0.05),and in patients with abnormal glucose metabolism group: the MRC score was severe The incidence of patients was significantly higher than that of mild and moderate patients;at the same time,we also found that the incidence of hyponatremia in patients with abnormal glucose metabolism was significantly higher than that of normal glucose metabolism,and there were statistically significant differences(P<0.05);In the analysis of the proportion of the prognosis of the two groups of patients,it was found that the incidence of poor prognosis in the group with abnormal glucose metabolism was significantly higher than that in the normal group of glucose metabolism,and statistically revealed the presence of Significant difference(P <0.05).Correlation analysis of GBS patients with abnormal glucose metabolism: Of the 73 patients who met the criteria for enrollment in this study,55(75.3%)were normoglycemic patients and 18(24.7%)were abnormal glucose metabolism patients.Correlation analysis showed a significant positive correlation between MRC score(OR: 0.318,P = 0.006),prognosis(OR: 0.419,P = 0.000),hyponatremia(OR: 0.433,P = 0.007)and abnormal glucose metabolism.There was no significant correlation between sex,age,onset to admission time,onset to discharge,precursor history,swallow reflex,lung infection,and abnormal glucose metabolism.3 risk factors for poor prognosis of GBS patients:Of the 73 patients enrolled,10(13.7%)had poor prognosis during hospitalization.Of the 10 patients with poor prognosis of GBS,6 were male(60.0%)and 4 were female(40.0%),of which 7 were old(70%)and 3 were non-elderly(30%);those with normal glucose metabolism were Three patients(30.0%)had abnormal glucose metabolism in 7 patients(70.0%).A total of 6 patients(60.0%)with a history of precursor infection had a total of 4 patients(40.0%).In 10 patients with poor prognosis of GBS,mild,moderate,and severe GBS were 0(00%),2(20.0%),and 8(80.0%)cases during the peak of the disease;7 cases(70.0%)were hyperlipidemia patients;1 case(10.00%)were patients with medulla oblongata,2 cases(20.0%)were required for tracheal intubation and mechanical ventilation for respiratory muscle paralysis,and 5 cases were secondary to pulmonary infection.50.0%)Univariate analysis revealed that abnormal glucose metabolism(OR: 11.030,P<0.05),hyponatremia(OR: 6.854,P<0.05),and pulmonary infection(OR: 4.727,P<0.05)increased short-term prognosis of GBS patients.The risk factors.There was no statistically significant correlation between age,onset to discharge time,gender,MRC score,history of pre-infection,bulbar paralysis,respiratory muscle paralysis,and pulmonary infection with short-term prognosis.Further multivariate regression analysis showed that pulmonary infection and hyponatremia were not independent risk factors for poor prognosis in GBS patients.The independent risk factor for increasing the short-term prognosis of GBS patients was abnormal glucose metabolism(OR: 9.381;P<0.05).Conclusion:1.The incidence of GBS patients with abnormal glucose metabolism in this study group was 24.7%.2.Patients with GBS with abnormal glucose metabolism are prone to hyponatremia.3.The clinical symptoms of GBS patients with abnormal glucose metabolism are serious.4.Abnormal glucose metabolism is an independent risk factor for poor prognosis of GBS patients.