陈宏宇++申东方++宋荣蓉

[摘要] 目的 探讨吉兰巴雷综合征患者的电生理表现及分型。 方法 整群收集2012年1月—2014年8月在哈尔滨医科大学第一附属医院住院的178例GBS患者，分析其电生理表现，并根据临床及电生理表现分型。 结果 AIDP型117例（65.7%），AMAN型30例（16.9%），纯感觉性神经病型12例（6.7%），CNV型8例（4.5%），Fisher型6例（3.4%），AMSAN型1例（0.6%）。还有一些亚型重叠者，CNV合并纯感觉性神经病1例，Fisher合并AMAN型1例，Fisher合并纯感觉性神经病型2例。损伤以运动神经为主。20例出现神经传导阻滞。两人仅有F波异常。16例电生理表现无异常。 结论 该院178例吉兰巴雷综合症患者以AIDP型最为常见，各亚型有相互重叠。AIDP、AMAN型可出现神经传导阻滞。

[关键词] 吉兰巴雷综合征；神经电生理；亚型；神经传导阻滞

[中图分类号] R745.43 [文献标识码] A [文章编号] 1674-0742（2015）09（a）-0042-03

Electrophysiological Findings of 178 Patients with Guillain-Barre Syndrome

CHEN Hong-yu1， SHEN Dong-fang2， SONG Rong-rong2

1. Department of Neurology， Heilongjiang Forest Industry General Hospital， Harbin， Heilongjiang Province， 150001 China；2. Department of Neurology， Fourth Affiliated Hospital of Harbin Medical University， Harbin， Heilongjiang Province， 150001， China

[Abstract] Objective To investigate electrophysiological findings of 178 patients with guillain-Barre syndrome （GBS） and its subtypes. Methods 178 patients with GBS administered by the First Affiliated Hospital of Harbin Medical University between January 2012 and August 2014 were enrolled to analyze their electrophysiological findings， based on clinical manifestations and which they were classified. Results There were 117（65.7%）patients in AIDP type， 30 （16.9%）in AMAN type， 12（6.7%）in pure sensory neuropathy type， 8（4.5%）in CNV type， 6（3.4%） in Fisher type， 1（0.6%）in AMSAN type. In addition， there were overlap subtypes， including 1 case in both CNV and pure sensory neuropathy type， 1 case in both Fisher and AMAN type， 2 cases in both Fisher and pure sensory neuropathy type. Motor nerve injury was most common. Nerve block was found in 20 patients. 2 patients were found only with F wave abnormality and 16 patients were found normal in electrophysiological findings. Conclusion AIDP was the most common type of GBS in the 178 patients enrolled， in which overlap subtypes can be observed and nerve block can be found in patients of AIDP and AMAN.

[Key words] Guillain-Barre syndrome； Nerve electrophysiological characteristic； Subtypes； Nerve conduction block

吉兰巴雷综合征（Guillain-Barré syndrome，GBS）造成急性驰缓性麻痹的最常见的病因，它是一种急性多发性神经病，表现为不同程度的无力，多数患者有呼吸道或消化道的前驱感染症状。吉兰巴雷综合征可分为急性炎症性脱髓鞘性多发性神经病（acute inflammatory demyelinating polyneuropathy，AIDP）、急性运动性轴索性神经病（acute motor axonal neuropathy，AMAN）、急性运动感觉轴索型神经病（acute motor sensory axonal neuropathy ，AMSAN）、Miller-Fisher 综合征（Miller-Fisher syndrome，MFS）、颅神经型（cranial nerve variants，CNV），及其他分类。其中国际上认为AIDP为西方国家常见的GBS亚型，而AMAN则常见于中国和日本[1]。而国内的学者大多不同意这种观点。为探讨古兰巴雷综合征患者的电生理表现及分型。该研究通过回顾性收集2012年1月—2014年8月在哈尔滨医科大学第一附属医院住院的178例GBS患者，分析其电生理表现，并根据临床及电生理表现分型，现报道如下。

1 资料与方法