The Study of Prognostic Factors in Guillain-Barré Syndrome

Guillain-Barré症候群的預後因素研究

丁廣祥(Kwang-Shung Ting) ； 林健群(Jiann-Chyun Lin) ； 張民基(Min-Key Chang) ； 曹汶龍(Wen-Long Tsao)

《Journal of Medical Sciences》 12卷6期 (1992/06) Pp. 410-419

摘要

Guillain-Barré症候群為最常見之急性髓鞘脫失多發性神經病變，是目前造成急性下肢行動障礙的主因之一。本科自1985至1990年，共計31例病患，經持續追蹤並由其臨床發現及電生理檢查結果加以探討其預後因素，可得到以下結論：一、合併先發感染及急性肝炎患者，或接受肝炎疫苗者比率較高，但此因素與預後無關。二、併發自主神經功能異常或呼吸衰竭病患，預後不佳。三、腦脊髓液蛋白質量超過200 mg/dl，患者預後較差。四、神經電生理檢查若出現混合肌肉反應電位（compound muscle action potential）之振幅明顯降低（低於正常50％以下者）及肌電圖異常者，其預後較差。而神經傳導速度與預後並無明顯關聯。

關鍵字

Guillain-Barré症候群

並列摘要

Guillain-Barré syndrome (GBS) is the most common cause of acute inflammatory demyelinating disease. We studied the clinical course and electrophysiologic findings of GBS in 31 patients from 1985 to 1990. The result of the study suggested the incidence of antecedent illness and viral Hepatitis-B associated patients or Hepatitis-B vaccination induced GBS were higher than those from other reports. These antecedent or associated illnesses had no influence on the outcome of GBS. The major clinical indicator of a poor prognosis was autonomic dysfunction and ventilatory failure. High levels of protein (＞200 mg/dl) in the cerebrospinal fluid (CSF) were also observed in the patients with poor prognosis. These patients markedly reduced the amplitude of compound muscle action potential (CMAP) and had electromyogram (EMG) abnormalities. Nerve conduction velocity (NCV) had no direct influence on the outcome of GBS.

並列關鍵字

Guillain-Barré syndrome