Abstract：
Respiratory support is required in 20-30% of patients with Guillain-Barré syndrome (GBS). We investigated clinical and biological risk factors for mechanical ventilation (MV) in northeast China through a retrospective GBS study. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is a prognostic model for MV in patients with GBS, and its usefulness has been validated in several countries but not in China. Therefore, we intended to validate the EGRIS model in our GBS cohort.
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.
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.
摘要：
20-30％的格林-巴利综合征（GBS）患者需要呼吸支持。通过回顾性GBS研究，我们调查了东北地区机械通气（MV）的临床和生物学危险因素。ErasmusGBS呼吸功能不全评分（EGRIS）是GBS患者MV的预后模型，它的有用性已经在几个国家得到了验证，但在中国没有得到验证。因此,我们打算在GBS队列中验证EGRIS模型。
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。
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。
