| Objective: To collect clinical data of patients with Guillain-Barrésyndrome(GBS)in eastern China,and to analyze the clinical features of GBS in East China;and to explore the regional differences in clinical features of GBS compared with other regions.Methods: Retrospective analysis of 271 patients from Affiliated Hospital of Jining Medical University(January 2007 to September 2016)and 239 patients from Affiliated Hospital of Xuzhou Medical University(January 2010 to May 2016).To investigate the geographic difference of GBS,our data was compared with two Dutch studies(Jacobs,et al.,1998 and Fokke,et al.,2014),one study from Northeastern China(Ye,et al.,2013)and one from Southern China(Liu,et al.,2018).Continuous data not-normally distributed were presented as medians and interquartile ranges(IQR).The percentage between different studies was compared by Chi-square test.Analysis was performed with the SPSS 20.0 analysis software(IBM,Armonk,NY).A P value of < 0.05 was considered significant.Results: The clinical features of GBS patients in eastern China are both similar and heterogeneous.The median age of the patients was 51(interquartile range,35-63).The ratio of male to female was 1.2.52.2% of patients complained of antecedent events,which included upper respiratory tract infection(URTI)(34.3%),diarrhea(17.8%),surgery(1.2%)and gangliosides treatment(0.8%).After onset,38.4% of the patients had cranial nerveinvolvement and 15% had pain.8.5% needed mechanical ventilation.91.3% of patients demonstrated hyporeflexia or areflexia at the nadir.Cerebrospinal fluid albuminocytologic dissociation was found in 69.3% of patients.445 of 510patients(87.3%)underwent NCS within three weeks of developing neurological symptoms.Single nerve conduction studies were normal in 5.6%,demyelinating neuropathy in 33.0%,axonal neuropathy in 24.3% and unclassified neuropathy in 37.1%.After treatment,95.3% of patients displayed monophasic course and 4.5% suffered clinical fluctuation within 8 weeks.At 1year,84.8% of patients showed almost complete recovery;10.1% were left with various degrees of disability and 5.1% died.The clinical features of GBS patients in eastern China have some geographical heterogeneity.First,the pre-infection event in this study accounted for 52.2%,which was lower than that in the Dutch studies(52.2% vs 61.6%,P<0.05).The proportion of patients with URTI in the pre-infected species in our study was significantly less than the South China study(65.8% vs 80.6%,P<0.05),and the proportion of patients with diarrhea was higher(34.2% vs 19.4%,P<0.05).Second,the proportion of patients requiring mechanical ventilation and painful symptoms was lower than the Dutch studies(P < 0.05);the proportion of patients with neurological examinations with signs of hyperreflexia was lower than the Southern study(P < 0.05);Third,compared with the Dutch study,there was a significantly higher percentage of patients with monophasic course(95.3% vs85.0%,P< 0.05)and less patients with fluctuation after treatment(4.5% vs10%,P<0.05)in our study.Conclusion: The clinical features of GBS patients in eastern China are both similar and heterogeneous.Most patients with GBS have a history of pre-infection before onset,and those with upper respiratory tract infection are the main.In addition to the symptoms of weakness,some patients have cranial nerve involvement and pain performance,neuroelectrophysiological demyelinating type is more common than axonal type,most patients show a single-phase course after treatment and recover well.Compared with other studies,the proportion of patients with pre-infection,clinical pain and mechanical ventilation was low in the eastern China.Among them,the URTI in the pre-infection was lower than that in the south,and the diarrhea was higher than that in the south.Among the clinical signs,the proportion of patients with hyperreflexia in the eastern part of China is lower than that in the south. |
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