The Analysis Of Guillian-Barre Syndrome Manifestation Characters And The Relationship Between The Manifestation And The Prognosis

Objectives: Guillain-Barre syndrome(GBS), also known as acute inflammatory demyelinating polyneuritis(AIDP), is the disease which on the nerve root and demyelination of the peripheral nerves and small blood vessels around the lymphocytes and macrophages in the inflammatory response to the pathological features of an immune-mediated polyneuritis disease,it is the most common diseases which because of acute paralysis. Any age may be sick, the incidence rate was similar between men and women, the incidence increased on summer and autumn. Most patients with a precursor prior to the onset of infection, with a cold, fever or diarrhea. GBS has variety of clinical manifestations, but limb paralysis is the most common, followed by the sensory dysfunction, cranial nerves damage and autonomic nervous system damage. Most of GBS patients have the protein - cell dissociation phenomenon of cerebrospinal fluid, and the patients who have the normal pressure are more than others. GBS abnormal nerve EMG based mainly reflect its pathological changes, including segmental demyelination and axonal damage. In the domestic and overseas study, demyelinating damage are more than axonal damage and the prognosis of demyelinating damage patients are better than axonal damage. GBS general treatment is conventional B vitamins and other nutrients nerve symptomatic treatment, and enhancing care. Apart from the general treatment, there are intravenous immunoglobulin,plasma replacement,hormone therapy and other treatment methods.Immunoglobulin efficacy is very well. But whether hormone therapy is effective for GBS patients has not been sured.GBS clinical performances are mostly small sample studys, the country's largest sample researches are few, and the views of the relationship between the clinical performance and the prognosis are not totally consistent.Methods: Our research was a retuospective study,the data came from the information from the hospital on January 1, 2000 to March 2008 treated from Guillain - Barre syndrome patients with a total of 336 cases. With the general collection of clinical data: including gender, age, the incidence season; auxiliary inspection targets and therapeutic effects. Using the widespread international applications Hughes functional evaluation Scale score the patients at admission and duration and divided them into groups with resume rapid or slower. According the EMG of patients,the patients are divided into groups with axonal injury or demyelinating injury. According to the different treatments,the patients are divided into hormone therapy group and IVIG treatment group.Between the various groups of patients,the Hughes score recovery will be compared.Result: 59.22% patients are male and others are female.There are 44.94% patients are the age of 20 to 40 years old.The maximum precursor factors is diarrhea, accounting for 59.15%, followed by upper respiratory tract infection symptoms, accounting for 42.61%; In this study, the most of first symptom is limb weakness, accounting for 68.75%.The average of 336 cases of peak illness condition is 7.6±6.3 days.63.39% patients'tendon reflexes are disappear; In this study, 45.83% patients have the symptom of limb numbness; following the patients who have the felt diminish signs (22.91%); Facial nerve damage is the most common cranial nerve damage,accounting for 34.82%; urinary retention is the most common damages which accounting 5.95% in autonomic nerve damages;and lung infection accounted for 6.84 percent.Protein-cell dissociation of cerebrospinal fluid is accounting for 92.47%.Axonal damage is accounted for 41.4%; demyelinating damage is accounted for 25.9%; the faster reinstate percentage of axonal and demyelinating damages is 25.32% and 56.25%,afterΧ~2 test,P<0.05.The faster reinstate percentage of hormone and immunoglobulin treatment is 54.55% and 56.72%, afterΧ~2 test, P> 0.05.Conclusions: This study showed that the male GBS patients are more than female,more common to young adults and pathogenesis in summer. Most of precursor infections are gastrointestinal symptoms and upper respiratory infected symptoms. The most first symptoms is limb weakness. The onsets of the peak often need nearly a week.GBS patients have more development forms of the disease. GBS patients have the sensory dysfunction of feeling diminishes which kind of gloves,subjective more than objective symptoms;there also can be appeared the symptoms of muscle pain.The most cranial nerve damages is the facial nerve damage, followed by the glossopharyngeal, vagus and abducens nerve damage.The most common dysfunctions of autonomic nervous system is urinary retention, followed by sinus tachycardia and hypertension.The protein-cell dissociation phenomenon of cerebrospinal fluid is common, cerebrospinal fluid pressure were normal. Axonal damage of EMG patients are more than demyelinating damage patients.The prognosis of patients with demyelinating damage are better than the axonal damage patients. GBS patients with hormone therapy and IVIG therapy both have the better efficacy.