A total of 252 patients with GBS were included in this study from January 2013 to October 2017. Risk factors for MV were identified via multivariate logistic regression analysis. The prognostic value of the EGRIS was validated via receiver operating characteristic curve analysis.
Thirty-one patients (12.3%) required MV (mean age 54.19 years), with a majority being male (77.4%). The risk factors for MV were male sex [odds ratio (OR) 3.720, 95% confidence interval (CI) 1.155-11.985, p < 0.05], shorter interval from onset to admission (OR 0.830, 95% CI 0.711-0.970, p < 0.05), lower Medical Research Council sum score at admission (OR 0.942, 95% CI 0.911-0.973, p < 0.001), neutrophil-to-lymphocyte ratio at admission (OR 1.174, 95% CI 1.049-1.315, p < 0.01), and cranial nerve deficit (OR 3.805, 95% CI 1.373-10.541, p < 0.05). The EGRIS had a good predictive ability for MV (area under the receiver operating curve 0.861) in patients with GBS, and a high EGRIS was a predictor for MV (OR 8.778, 95% CI 3.432-22.448, p < 0.001). However, there was no significant difference in ganglioside administration between ventilated and nonventilated patients.
An elevated neutrophil-to-lymphocyte ratio at admission and a high EGRIS could serve as predictors for MV in our GBS cohort.
从2013年1月至2017年10月,共纳入252例GBS患者。通过多因素logistic回归分析确定MV的危险因素。通过受试者工作特征曲线分析验证了EGRIS的预后价值。
31名患者(12.3%)需要MV(平均年龄54.19岁),大多数是男性(77.4%)。MV的危险因素是男性[优势比(OR)3.720,95%置信区间(CI)1.155-11.985,p<0.05],从发病到入院的间隔较短(OR0.830,95%CI0.711-0.970,p<0.05),入院时医学研究委员会总分较低(OR0.942,95%CI0.911-0.973,p<0.001),入院时的中性粒细胞与淋巴细胞比率(OR1.174,95%CI1.049-1.315,p<0.01),和颅神经缺损(OR3.805,95%CI1.373-10.541,p<0.05)。EGRIS对GBS患者的MV(受试者工作曲线0.861下面积)具有良好的预测能力,高EGRIS是MV的预测因子(OR8.778,95%CI3.432-22.448,p<0.001)。然而,通气和不通气患者的神经节苷脂给药无显著差异.
在我们的GBS队列中,入院时中性粒细胞与淋巴细胞比率升高和高EGRIS可以作为MV的预测因子。