The Prediction Effects Of Thyroid Function In The Severity Of Guillain-Barré Syndrome

Objective: To investigate the role of thyroid function and thyroid autoantibodies in the severity of GBS disease and its short-term prognosis,and to study the predictive value of EGRIS score combined with thyroid function for GBS respiratory insufficiency.Materials and methods:We retrospectively analyzed the clinical data of 219 GBS patients.According to the thyroid function,the enrolled subjects were divided into 2groups,that is,patients with abnormal thyroid function（case group）and those with normal thyroid function（control group）.The clinical characteristics,disease severity,and short-term prognosis of the patients in 2 groups were compared.In addition,we also divided the 219 GBS patients into mechanical ventilation（MV）group and nonMV group according to whether MV was performed within one week after admission.The clinical characteristics,disease severity,short-term prognosis,Erasmus GBS respiratory insufficiency score（EGRIS）and the thyroid function were compared in the two groups.Results: We found that GBS patients with abnormal thyroid function had longer duration of hospitalization,higher frequency of cranial nerve,and higher incidence of weakened tendon reflexes.Medical Research Council（MRC）scores on admission,at nadir,and at discharge were lower and Hughes functional Grading Scale（HFGS）scores on admission,and at discharge were higher in GBS patients with abnormal thyroid function group.More patients in abnormal thyroid function group had myelin,axonal,and myelin-axonal injuries.In MV group,the time from onset to admission,MRC scores on admission,and the levels of free triiodothyronine（FT3）were lower,and the levels of thyroglobulin antibody（Tg Ab）and EGRIS were significantly higher than those in non-MV group.The combination of EGRIS and FT3 serum levels to predict GBS patients with MV,the area under curve（AUC）was 0.905（95% CI: 0.861 to 0.948,p<0.05）,sensitivity was 88.9% and specificity was 84.7%.Conclusion:Our results suggest that the serum FT3 levels are negatively correlated with disease severity,the serum FT3 levels may correlate with GBS disease severity.Both EGRIS and serum FT3 have a predictive value for the occurrence of acute respiratory insufficiency in GBS patients,and the combination of these two indicators can more accurately predict the risk of acute respiratory insufficiency in GBS patients.