| Guillain-Barre Syndrome(GBS), i.e, acute inflammatory demyelinatingpolyneuropathies, is an autoimmune disease characterized by demyelinating inperipheral nerves and nerve roots and inflammatory reaction on lymphocyteand megaphocyte. It,s etiology remains not very clear, most of the patientshave a infection history of upper respiratory tract or diarrhea. Some has ahistory of vaccinating. According to the molecular mimicry mechanism,because some components of the pathogen are similar to that of peripheralnerves, the human,s immunity system cannot discern it correctly, then excretesauto-immunity T cell and auto-antibodies and responses to the components ofthe PNS, causing the demyelinating on peripheral nerves. Nowadays, themainstay treatment is the causal treatment which based on supportingtreatment, that is, to regulate body,s immunity system, eliminate pathogenicfactors and promote regenerating of the nerve and remyelinating of the sheath.The glucocorticosteroid is the earliest medicine applied to GBS. Recently,plasma exchange, immunoadsorption and intravenous immunoglobulin aregradually applied and have manifested a better effect. IVIG, because it is easyto use and has a confirmed effect, is the most popular medicine for GBS now.Although someone has reported that glucocorticosteroid was useless to GBS,the animal experiments show that glucocorticosteroid is effective to EAN. Soglucocorticosteroid is still applied to GBS extensively. Our research observed 40the effect of combining glucocorticosteroid and intravenous immunoglobulinon treating severe GBS and compared it to that which only glucocorticosteroidwas applied then gave it a comprehensive evaluation. From Jan. of 1998 to Jan. of 2004, 67 severe patients who receivedtreatment in our department were admitted in this study. All patients wereclinically diagnosed GBS. Glucocorticosteroid was given to 35 cases. Afterdiagnosed, the 35 patients received intravenous DXM 10mg/d for 7 days onthe base of supportive treatment, then reduced the dosage gradually. At thesame time, intrathecally DXM 5mg applied to those who had no dyspneaevery 3 days, totally 3 times. 32 cases received IVIG(0.4mg/kg/d, totally 5days, produced by Harbin biochemistry institute) additionally. Evaluated thegrade before treatment and on the seventh and fourteenth day after treatmentrespectively according to Hughes scale, compared the effective time and thedecrease of the Hughes grade of the 2 groups by t test, then compared the validrate of the two groups by X2 test by PC.SPSS software. Change of MCV wasalso recorded and meliorating of dyspnea was observed particularly. The two groups had no significant difference in age, sex, course andHughes scale(P>0.05)before treatment。Patients with severe infection,tuberculosis, diabetes and other severe viscera dysfunction were excluded.Evaluated the curative effect by assessing the improving grade of Hughesscale: There was no statistic difference by Hughes scale beforetreatment(P>0.05) between two groups,but on the 7th day, 14th day and 21thday after treatment, there were significant difference (P<0.01,P<0.02respectively). Compared the course of improving 1 and 2 grades according toHughes scale of two groups, we found that the course of the combined group 41was significantly shorter than that of the DXM group (P<0.01). The valid rateof the combined group were slightly higher than that of the DXM group( 90.63% and 82.85% respectively)when evaluated on the 21th day (P>0.05).IVIG could alleviate dyspnea swiftly and could promote the recovery of MCV.The risk of onset of side effects was 8.57% for DXM group, 9.37% forcombined group. No severe side effects appeared during treatment. Conclusions: IVIG combined with GS on treating GBS excelled thatwhich using GS only on clinical effective time, on improving Hughes scaleand effective rate. IVIG combined...
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