| ObjectiveGuillain-Barre syndrome(GBS)is a common autoimmune peripheral neuropathy characterized by rapidly progressive extremities weakness,sensory and autonomic nerve damages,and cerebrospinal fluid albuminocytologic dissociation.The prognosis of GBS patients is very different,some patients can leave severe disabilities and even death.The current analyses on the prognostic factors of GBS are limited.This study retrospectively analyzed the GBS patients diagnosed and treated in Qilu Hospital of Shandong University from 2010 to 2019,summarized the clinical characteristics of GBS patients,evaluated the prognosis of GBS patients,and discussed the factors affecting the prognosis.MethodsGBS cases diagnosed and treated in Qilu Hospital of Shandong University from 2010 to 2019 were collected,and their clinical data were analyzed.The prognosis of GBS patients was followed up,and the factors affecting prognosis were analyzed by Logistic regression.ResultsClinical data were collected from 394 patients.Males were more than females,accounting for 56.1%.There was no significant difference in gender composition in different age groups.The number of patients in summer and winter was higher,accounting for 57.4%in total.There was no significant difference in gender composition in different seasons.The prodromic events were mainly respiratory tract infection and gastrointestinal tract infection,accounting for 42.9%of all patients.The initial symptoms were mainly limb weakness,limb weakness with numbness and limb numbness,accounting for 76.1%in total.The average length of hospitalization was 12.25±0.420 days.Common chronic comorbidities such as hypertension,diabetes and/or coronary heart disease accounted for 31.0%.Patients with cranial nerve involvement accounted for 39.6%.And the muscle strength in 90.4%patients were affected at both proximal and distal ends.49.5%of patients had abnormal senses.The tendon reflex was reduced or disappeared in 93.9%of patients.The patients with autonomic nerve involvement accounted for 42.9%.Albuminocytologic dissociation was found in 73.8%of patients.77.4%of the patients were found abnormalities on NCV The proportion of patients with increased creatine kinase was 21.9%.Independent sample t test and analysis of variance showed that there were differences in creatine kinase levels between different genders and ages in GBS patients.The main treatment method was intravenous human immunoglobulin(77.4%),and another 4.6%of the patients received immunoglobulin combined with steroid therapy,plasma exchange only accounted for 0.3%.26.9%of the patients needed oxygen therapy and auxiliary ventilation.4.6%of patients required ICU transfer.Mild patients accounted for 52.5%and severe patients 47.5%.There were no significant differences in gender composition,season of onset,prodromal events,the days before admitted to hospital,complications of common chronic diseases,cranial nerve involvement,amyotrophy,pathological reflex,and creatine kinase level between severe patients and mild patients.There were significant differences in ages(p=0.004),initial symptoms(p=0.028),hospitalization days(p=0.001),muscle weakness pattern(p=0.000),muscle weakness areas(p=0.000),coordination movement(p=0.000),paraesthesia(p=0.025),tendon reflex(p=0.001),autonomic nerve involvement(p=0.000),CSF albuminocytologic dissociation(p=0.001),lumbar puncture pressure(p=0.045),CSF protein(p=0.000),CSF igG(p=0.000),nerve conduction velocity(p=0.028),Hughes score at discharge(p=0.000),and treatment effect(p=0.000)between severe patients and mild patients.Logistic regression analysis suggested that age,season,different cranial nerve involvement,and grading of muscle strength might be risk factors for poor short-term prognosis(? Hughes?0)in GBS patients.Conclusions1.Male patients were more common,the onsets of disease in summer and winter were more common.Respiratory and gastrointestinal tract infections were the most common prodromic events to GBS.Limb weakness+numbness were the mainest initial symptoms of GBS.Facial,glossopharyngeal vagus and autonomic nerve involvements were common manifestations of GBS.Muscle weakness at both ends of the limb was the mainest pattern.2.Patients with advanced age,severe motor and sensory involvement,autonomic nervous dysfunction,and/or high CSF protein and CSF IgG might have an increased risk to become severe patients.3.Age,season,different cranial nerve involvement,and grading of muscle strength might be risk factors for poor short-term prognosis(? Hughes?0)in GBS patients GBS patients who are older age,develop the disease in autumn or winter,have facial nerve or accessory nerve damage,and have worse muscle strength grade are more likely to have a poor prognosis. |
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