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目的观察大剂量免疫球蛋白治疗吉兰—巴雷综合征(GBS)的临床效果。方法将68例GBS患者随机分为观察组34例和对照组34例,两组入院后均行相同方案的常规治疗;观察组在此基础上静滴大剂量免疫球蛋白,400 mg/(kg·d),连续应用5 d。两组于治疗前及治疗28 d时参照国际标准进行肌力评分,统计两组肌力开始恢复时间及总住院时间,评价两组临床治疗效果及不良反应。采用SPSS 20.0统计软件。计量资料以(xˉ±s)表示,采用t检验;计数资料以率的形式表示,比较采用χ2检验。以P<0.05为差异有统计学意义。结果治疗后两组上肢、下肢肌力评分均较治疗前升高(均P<0.05),且观察组升高幅度均大于对照组(均P<0.05)。观察组平均肌力开始恢复时间为(12.93±5.34)d、总住院时间为(23.82±5.38)d,对照组分别为(17.46±6.83)、(30.82±7.32)d,两组比较均P<0.05。观察组治疗总有效率为91.17%,高于对照组的76.47%(P<0.05)。观察组不良反应发生率为23.52%,对照组为17.64%,两组比较差异无统计学意义(P>0.05)。结论大剂量免疫球蛋白治疗GBS临床疗效较好,安全性较好。
Objective To observe the clinical effect of high-dose immunoglobulin in treating Guillain-Barre syndrome (GBS). Methods Sixty-eight patients with GBS were randomly divided into observation group (34 cases) and control group (34 cases). Both groups received routine treatment of the same protocol after admission. On the basis of this study, intravenous infusion of high-dose immunoglobulin, 400 mg / kg · D), continuous application of 5 d. Before treatment and at 28th day of treatment, muscle strength was scored according to international standards. The onset time of muscle strength and total length of stay in the two groups were calculated. The clinical effects and adverse reactions in both groups were evaluated. Using SPSS 20.0 statistical software. Measurement data to (xˉ ± s), using t test; count data in the form of rate, compared with the χ2 test. P <0.05 for the difference was statistically significant. Results After treatment, the scores of muscle strength of upper extremity and lower extremity in both groups were significantly higher than those before treatment (both P <0.05), and the increasing amplitude in the observation group was higher than that in the control group (all P <0.05). The average time to start recovery was (12.93 ± 5.34) d in the observation group and (23.82 ± 5.38) days in the control group, (17.46 ± 6.83) and (30.82 ± 7.32) days in the control group, respectively, P < 0.05. The total effective rate of observation group was 91.17%, higher than 76.47% of control group (P <0.05). The incidence of adverse reactions in the observation group was 23.52% and in the control group was 17.64%. There was no significant difference between the two groups (P> 0.05). Conclusion High-dose immunoglobulin is a safe and effective treatment for GBS.