【摘要】 目的对吉兰-巴雷综合征(GBS)进行临床及系列神经电生理观察,以进一步指导临床应用。方法纳入急性炎性脱髓鞘性多发性神经根神经病(AIDP)患者26例,急性运动轴索性神经病(AMAN)患者14例,在发病2、4、12周行神经电生理检查。收集患者的临床资料以及神经电生理参数。分析比较AIDP及AMAN患者临床、神经电生理特点。结果 AMAN组腹泻的发生率高于AIDP(P<0.05)。AMAN感觉异常出现率小于AIDP(P<0.05)。AIDP运动末梢潜伏期(DML)、运动传导速度(MCV)、远端复合肌肉动作电位(dCMAP)波幅异常均在4周左右达到高峰(P<0.05),到第12周仍未恢复正常;感觉神经动作电位(SNAP)波幅、感觉传导速度(SCV)异常出现晚于运动神经,下肢异常晚于上肢;F波在发病2周内出现率降低,潜伏期延长。而AMAN电生理异质性明显,部分患者dCMAP波幅持续性降低,部分患者dCMAP波幅恢复较快。结论通过系统观察AIDP与AMAN临床和电生理特点,可以更好地了解疾病进程、评估预后。更多还原

【Abstract】 Objective To investigate clinical manifestations and serial electrophysiological changes of acute inflammatory demyelinating polyneuropathy(AIDP)and acute motor axonal neuropathy(AMAN).Methods Collect 26 AIDP cases and 14 AMAN cases.Electrophysiological tests were performed at the 2nd,4th and 12 th weeks after disease onset.Clinical and electrophysiological characteristics of AIDP and AMAN groups were analyzed.Results There were statistically significant differences in preceding gastroenteritis and sensory symptoms between AIDP and AMAN groups(P<0.05).In AIDP group,DML prolongation,MCV slowing and dCMAP decrease were prominent at 4th week(P<0.05).Until 12 th week,they were not recovered completely.In AIDP group,sensory nerves were involved later than motor nerves,and sensory nerves of lower limbs were involved later than upper limbs.F wave frequency was decreased and F wave lantency was prolonged in the first 2weeks in AIDP group.Electrophysiology of AMAN cases differed significantly:someone with persistent lower amplitude of dCMAP and someone with rapid recovery of dCMAP.Conclusion Clinical diagnosis and prognosis can be evaluated by clinical manifestations and serial changes of electrophysiology.更多还原