| Objective: Guillain-Barre Syndrome(GBS)is an inflammatory peripheral neuropathy,and its pathogenesis has not been fully elucidated,but the immunological mechanism has been widely declared in recent years.This study aims to conduct a retrospective analysis of the clinical manifestations and prognosis of patients with GBS and positive anti-ganglioside antibodies,and study the correlation between the types of antibodies and clinical manifestations and prognosis,thus helping guide clinical treatment and prognosis analysis.Methods: 33 patients diagnosed with GBS and positive anti-ganglioside antibody and admitted to various hospitals in Qingdao from January 2018 to January 2020 were included.Clinical data,laboratory data and disease-related factors were collected and retrospectively analyzed,and prognosis was also explored.Results: Among the 33 patients,21 cases(63.6%)had limb weakness.The peak age of disease onset was around 40-51 years old.20 cases(61%)were male,accounting for the majority.The prognosis of men and women was not statistically significant(P>0.05).9cases(27%)were children,and their incidence was lower than that of adults.Children's Hughes peak score was lower than that of adults(P<0.0001),and the ?Hughes score was also lower than that of adults(P<0.05).In patients with positive GM1 antibody,20 cases(100%)had limb weakness;in patients with negative GM1 antibody,1 case(7.7%)had limb weakness;Chi-square test for GM1 and limb weakness showed P<0.00001;GM1antibody is closely related to limb weakness.In patients with positive GQ1 b antibody,7cases(87.5%)had ocular muscle paralysis;in patients with negative GQ1 b antibody,5cases(20%)had ocular muscle paralysis;Chi-square test for GQ1 b and ocular muscle paralysis showed P=0.001;Ophthalmoplegia is closely correlated with anti-GQ1 b antibody.In patients with positive GT1 a antibody,9 cases(56.3%)had ocular muscle paralysis;in patients with negative GT1 a antibody,3 cases(17.6%)had ocular muscle paralysis;Chi-square test for GT1 a and ocular muscle paralysis showed P=0.032;Ophthalmoplegia is closely correlated with anti-GT1 a antibody.In patients with positive GD1 a antibody,6 cases(85.7%)had facial palsy;in patients with negative GD1 a antibody,1 case(3.8%)had facial muscle palsy;Chi-square test for GD1 a and facialmuscle palsy showed P=0.000043;Facial nerve palsy is related to anti-GD1 a antibody.In patients with positive GT1 a antibody,8 cases(50%)had medullary palsy;in patients with negative GT1 a antibody,1 case(5.9%)had medullary palsy;Chi-square test for GT1 a and medullary palsy showed P=0.007;Bulbar paralysis is correlated with anti-GT1 a antibody.In patients with positive GQ1 b antibody,7 cases(87.5%)had ataxia;in patients with negative GQ1 b,1 case(4%)had ataxia;Chi-square test for GQ1 b and ataxia showed P<0.05;Ataxia is related to anti-GQ1 b antibody.In patients with positive GD1 a antibody,2 cases(28.6%)were mechanical ventilation;in patients with negative GD1 a antibody,7cases(26.9%)were mechanical ventilation;Chi-square test showed no correlation between GD1 a antibody and mechanical ventilation(P=1.0);No positive correlation between anti-GD1 a antibody and mechanical ventilation is founded,which may be due to small sample size.The patients with positive GM1 b antibody had higher ?Hughes score than those with negative GM1 b antibody(P=0.0025),suggesting that prognosis of patients with positive GM1 b antibody was worse than those with negative GM1 b antibody.The patients with positive GD1 a antibody had higher ?Hughes score than those with negative GD1 a antibody(P<0.0001),suggesting that prognosis of patients with positive GD1 a antibody was worse than those with negative GD1 a antibody.Conclusions:(1)The clinical manifestations of GBS are varied,and the clinical diagnosis requires comprehensive judgment,which not only presents limb weakness,but may only present dysphagia.As a result,rare clinical manifestations such as acute bulbar paralysis cannot be excluded from the diagnosis of GBS.(2)Compared with adults,children have lower morbidity,relatively mild symptoms,and relatively better prognosis.(3)Antiganglioside antibody subtypes are correlated with clinical manifestations and prognosis,which can guide clinical diagnosis and prognosis. |
PDF Full Text Request