PDF(Pubmed)
Abstract：
Respiratory muscle paralysis is known as a very common complication of Guillain-Barré syndrome (GBS). However, most research has focused on its later stages rather than its earlier stages, including the prognosis of patients with this condition, or factors that act as early predictors of risk. Therefore, our study aimed to identify early predictors of respiratory muscle paralysis in patients with GBS and determine the short-term prognosis of such patients. We recruited 455 GBS patients (age ≥ 18) who had been hospitalized in the First Affiliated Hospital of Harbin Medical University between 2016 and 2021, retrospectively. We recorded clinical and laboratory data and used linear and logistic regression analysis to investigate the relationship between early clinical, examination results, and subsequent respiratory muscle paralysis. Among the 455 patients, 129 were assigned to a respiratory muscle paralysis group and 326 were assigned to a non-respiratory muscle paralysis group. Compared with the non-affected group, the time from onset to admission was shorter (p = 0.0003), and the Medical Research Council (MRC) score at admission and discharge was smaller in the affected group (p < 0.0001). Compared with the non-affected group, the affected group had higher Hughes and Erasmus GBS Respiratory Insufficiency Score (EGRIS) scores at admission and longer hospital stays (p < 0.0001). Patients in the affected group were more likely to have bulbar palsy and lung infections (p < 0.0001). To conclude, bulbar palsy, a higher EGRIS score and Hughes score at admission, a lower MRC score, and a shorter time between onset and admission, are all predictive risk factors for respiratory muscle paralysis in patients with GBS. An increase in any of these factors increases the risk of muscle paralysis. Patients with respiratory muscle paralysis have a poorer short-term prognosis than those without respiratory muscle paralysis. Therefore, we should attempt to identify patients with one or more of these characteristics in the early stages of admission, provide ventilation management, and administer IMV treatment if necessary.
摘要：
呼吸肌麻痹是格林-巴利综合征（GBS）的一种常见并发症。然而,大多数研究都集中在后期，而不是早期，包括患有这种疾病的患者的预后，或作为风险早期预测因子的因素。因此,本研究旨在确定GBS患者呼吸肌麻痹的早期预测因素,并确定此类患者的短期预后.我们回顾性招募了2016年至2021年在哈尔滨医科大学附属第一医院住院的455例GBS患者（年龄≥18岁）。我们记录了临床和实验室数据，并使用线性和逻辑回归分析来研究早期临床和实验室之间的关系。检查结果,以及随后的呼吸肌麻痹。在455名患者中，129个被分配到呼吸肌麻痹组，326个被分配到非呼吸肌麻痹组。与非患组相比,从发病到入院的时间较短（p=0.0003），入院和出院时的医学研究委员会（MRC）评分在受影响的组中较小（p<0.0001）。与非患组相比,受累组入院时Hughes评分和ErasmusGBS呼吸功能不全评分(EGRIS)评分较高,住院时间较长(p<0.0001).受影响组的患者更容易出现球麻痹和肺部感染（p<0.0001）。最后，球麻痹,更高的EGRIS分数和Hughes分数，较低的MRC分数,发病和入院之间的时间更短，都是GBS患者呼吸肌麻痹的预测危险因素。任何这些因素的增加都会增加肌肉麻痹的风险。与没有呼吸肌麻痹的患者相比，呼吸肌麻痹的患者短期预后较差。因此,我们应该在入院的早期阶段尝试识别具有一个或多个这些特征的患者，提供通风管理，并在必要时进行IMV治疗。
