Subtypes And Prognosis Of Guillain-barré Syndrome

Objective:Guillain-Barré syndrome(GBS) is one of potentially life-threatening diseases af ter infection,and its characteristic is to progress rapidly,symmetrical distal limb we akness. Based on electrophysiology and neuropathology, Guillain-Barré syndrome in cludes two main types: Acute inflammatory demyelinating polyneuropathy(AIDP) a nd Acute motor axonal neuropathy(AMAN).It is generally believed that AMAN ha ve a poor prognosis, while AIDP prognosis is good, this article will study the pr ognosis of AMAN and AIDP respectively and the factors affecting the prognosis.Methods:This paper mainly collects patients with GBS diagnosed by the first affiliated hospital of shanxi medical university, it is a retrospective study on 2013-2015. A total of 87 patients meet the diagnostic criteria of GBS described by Asbury. All patients’ clinical data, laboratory examination and electrophysiological data, treatment and recovery of data can be recorded. According to Hadden’s diagnostic criteria, we could divide the patients into AMAN group, AIDP group and unclassifiable group.The patients have an electrophysiological examination after 2 or 3 weeks. We evaluate the GBS disability degree by Hughes scores. The patients come back to the hospital for a check through the outpatient.Results:1. There are 46 patients diagnosed with AMAN, and a total of 31 patients a re diagnosed with AIDP. A total of 10 people belong in unclassifiable group. 2. There are a total of 38 people with GBS having poor prognosis(43.7%), Factors with poor prognosis including(1). The disease attack unilateral limb at first(2). Pe ak of Hughes scores(3). Hughes score at the end of the first month after onset of symptoms(4). Autonomic dysfunction(5). Mechanical ventilation(6). For seri ously sick patients(peak of Hughes scores ≥ 4), Glucocorticoid with intravenous i mmunoglobulin. 3. There are a total of 23 people with AMAN having poor prog nosis(50%), Factors with poor prognosis including(1). Peak of Hughes scores(2). Hughes score at the end of the first month after onset of symptoms(3). Autono mic dysfunction(4). Mechanical ventilation 4. There are a total of 14 people wit h AIDP having poor prognosis(45.2%), Factors with poor prognosis including(1). Peak of Hughes scores(2). Hughes score at the end of the first month after onse t of symptoms(3) For seriously sick patients(peak of Hughes scores ≥ 4), Gluco corticoid with intravenous immunoglobulin.Conclusion:The prognosis of patients with AIDP is better than the patients with AMAN, but the difference between the two is small(54.8% : 54.8%). The factors affecti ng the prognosis rely mainly on clinical symptoms including initial symptoms, th e crest-time of symptoms, whether to use mechanical ventilation, and presence of autonomic dysfunction. In addition, For the treatment, glucocorticoid with intraven ous immunoglobulin has poorer prognosis than using intravenous immunoglobulin individually.