急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病臨床治療探討

張鳳媛

[摘要] 目的 探討急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病的治療效果。方法 收集2009年—2014年遼西醫(yī)學(xué)院附屬醫(yī)院急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病患者共62例，進(jìn)行治療的回顧性分析。結(jié)果 62例患者經(jīng)系統(tǒng)性綜合治療，總有效率為90.32%，其中治愈36例，好轉(zhuǎn)20例，自動(dòng)出院4例，死亡2例；IVIG組與PE組治療有效率比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 綜合治療能有效治療急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病；IVIG組與PE組治療效果無太大差別，各醫(yī)院可以根據(jù)自身硬件條件開展不同的治療方案。

[關(guān)鍵詞] 急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病；免疫球蛋白靜脈注射；血漿置換

[中圖分類號(hào)] R4 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2015）05（a）-0056-02

Clinical Study on Treatment of Acute Inflammatory Demyelinating Polyneuropathy

ZHANG Feng-yuan

Department of internal medicine，Jinzhou Health School，Jinzhou，Liaoning Province，121000 China

[Abstract] Objective To explore the treatment effect of acute inflammatory demyelinating polyneuropathy.Methods 62 cases of patients with acute inflammatory demyelinating polyneuropathy in The Affiliated Hospital of Liaoning Medical University from 2009 to 2014 were collected ， then they were retrospectively analyzed the treatment. Results 62 cases of patients with comprehensive treatment ， the total effective rate was 90.32%， 36 cases were cured， 20 cases improved， 4 cases leave hospital automatically，there was 2 case of death； the effective rate of the treatment comparison between IVIG group and PE group is no significant difference （P>0.05）. Conclusion The comprehensive treatment is effective in the treatment of acute inflammatory demyelinating polyneuropathy；the therapeutic effect ist significant difference between the IVIG group and PE group， the hospital can carry out different treatment according to their own hardware conditions.

[Key words] Acute inflammatory demyelinating polyneuropathy；Intravenous immunoglobulin；Plasma exchange

急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病（Acute inflammatory demyelinating polyneuropathy AIDP）是一種自身免疫介導(dǎo)的周圍神經(jīng)病[1]，又稱吉蘭-巴雷綜合征（Guillain-Barre syndrome， GBS），臨床以四肢弛緩性癱瘓、腦脊液蛋白-細(xì)胞分離為特征，常合并腦神經(jīng)麻痹。AIDP患者主要受損部位是周圍神經(jīng)運(yùn)動(dòng)纖維，呈現(xiàn)出明顯脫髓鞘，并且是多伴有軸索損傷，但周圍神經(jīng)感覺纖維損傷不顯著[2]。AIDP是神經(jīng)內(nèi)科常見的危重癥之一，其病情進(jìn)展迅速，病死率比較高。該研究收集自2009年1月—2014年12月間遼寧醫(yī)學(xué)院附屬醫(yī)院收治的共62例急性炎癥性脫髓鞘性多發(fā)性神經(jīng)病患者，并對(duì)治療該病的臨床效果進(jìn)行了回顧性分析，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

62例患者中男34例，女28例，年齡16～65歲，平均41歲，發(fā)病時(shí)間在11 d之內(nèi)包括11 d，與中華神經(jīng)精神科雜志編委1993年10月制定的格林-巴利綜合征診斷標(biāo)準(zhǔn)相一致[3]。患者……