儿童吉兰-巴雷综合征需要辅助呼吸的危险因素分析

李承, 孙瑞迪, 冯丽, 江军

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (9) : 922-926.

PDF(491 KB)
HTML
PDF(491 KB)
HTML
中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (9) : 922-926. DOI: 10.7499/j.issn.1008-8830.2106003
论著·临床研究

儿童吉兰-巴雷综合征需要辅助呼吸的危险因素分析

  • 李承, 孙瑞迪, 冯丽, 江军
作者信息 +

Risk factors associated with the need for mechanical ventilation in children with Guillain-Barré syndrome

  • LI Cheng, SUN Rui-Di, FENG Li, JIANG Jun
Author information +
文章历史 +

摘要

目的 研究儿童吉兰-巴雷综合征(Guillain-Barré syndrome,GBS)需要辅助呼吸的危险因素。 方法 回顾性收集107例GBS患儿的临床资料。根据是否需要辅助呼吸,分为需要辅助呼吸组(n=16)和不需要辅助呼吸组(n=91)。比较两组患儿的临床资料,采用多因素logistic回归分析法分析GBS患儿需要辅助呼吸的危险因素。 结果 107例GBS患儿中,16例患儿需要辅助呼吸,发生率为15.0%。需要辅助呼吸组面肌和/或延髓肌无力比例高于不需要辅助呼吸组,起病到病情高峰期天数短于不需要辅助呼吸组,首次就诊休斯功能分级量表得分高于不需要辅助呼吸组(均P<0.05)。面肌和/或延髓肌无力、起病到病情高峰期天数短是GBS患儿需要辅助呼吸的危险因素(分别OR=5.053、1.239,P<0.05)。 结论 面肌和/或延髓肌无力和起病到病情高峰期天数的缩短可能增加GBS需要辅助呼吸的风险。 引用格式:

Abstract

Objective To study the risk factors associated with the need for mechanical ventilation in children with Guillain-Barré syndrome (GBS). Methods The medical data of 107 children with GBS were retrospectively reviewed. According to whether mechanical ventilation was required, the children were divided into a mechanical ventilation group with 16 children and a non-mechanical ventilation group with 91 children. The risk factors associated with the need for mechanical ventilation in children with GBS were identified by a multivariate logistic regression analysis. Results Among the 107 children, 16 (15.0%) required mechanical ventilation. Compared with the non-mechanical ventilation group, the mechanical ventilation group had a significantly higher proportion of children with facial and/or bulbar muscle weakness, a significantly shorter duration from the onset to the peak of the disease, and a significantly higher Hughes Functional Grading Scale score at the first visit (P<0.05). Facial and/or bulbar muscle weakness and short duration from the onset to the peak of the disease were risk factors associated with the need for mechanical ventilation in children with GBS (OR=5.053 and 1.239 respectively, P<0.05). Conclusions Facial and/or bulbar muscle weakness and short duration from the onset to the peak of the disease may increase the risk of mechanical ventilation in children with GBS. Citation:

关键词

吉兰-巴雷综合征 / 辅助呼吸 / 儿童

Key words

Guillain-Barre syndrome / Mechanical ventilation / Child

引用本文

导出引用
李承, 孙瑞迪, 冯丽, 江军. 儿童吉兰-巴雷综合征需要辅助呼吸的危险因素分析[J]. 中国当代儿科杂志. 2021, 23(9): 922-926 https://doi.org/10.7499/j.issn.1008-8830.2106003
LI Cheng, SUN Rui-Di, FENG Li, JIANG Jun. Risk factors associated with the need for mechanical ventilation in children with Guillain-Barré syndrome[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(9): 922-926 https://doi.org/10.7499/j.issn.1008-8830.2106003

参考文献

1 Karalok ZS, Taskin BD, Yanginlar ZB, et al. Guillain-Barré syndrome in children: subtypes and outcome[J]. Childs Nerv Syst, 2018, 34(11): 2291-2297. PMID: 29948140. DOI: 10.1007/s00381-018-3856-0.
2 Singh S, Gupta N, Gupta AM, et al. Clinical profile and predictors for outcome in children presenting with Guillain-Barré syndrome[J]. J Family Med Prim Care, 2020, 9(10): 5316-5319. PMID: 33409208. PMCID: PMC7773083. DOI: 10.4103/jfmpc.jfmpc_951_20.
3 Barzegar M, Toopchizadeh V, Golalizadeh D, et al. A predictive model for respiratory failure and determining the risk factors of prolonged mechanical ventilation in children with Guillain-Barre syndrome[J]. Iran J Child Neurol, 2020, 14(3): 33-46. PMID: 32952580. PMCID: PMC7468085.
4 Estrade S, Guiomard C, Fabry V, et al. Prognostic factors for the sequelae and severity of Guillain-Barré syndrome in children[J]. Muscle Nerve, 2019, 60(6): 716-723. PMID: 31531862. DOI: 10.1002/mus.26706.
5 Luo HY, Hong SQ, Li M, et al. Risk factors for mechanical ventilation in children with Guillain-Barré syndrome[J]. Muscle Nerve, 2020, 62(2): 214-218. PMID: 32367533. DOI: 10.1002/mus.26905.
6 Altaweel YA, Abdelaziz S, Fathy HA, et al. Correlative study between C-reactive protein, clinical severity, and nerve conduction studies in Guillain-Barrè syndrome[J]. Egypt J Neurol Psychiatr Neurosurg, 2018, 54(1): 4. PMID: 29780224. PMCID: PMC5954777. DOI: 10.1186/s41983-018-0006-2.
7 Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome[J]. Lancet, 2016, 388(10045): 717-727. PMID: 26948435. DOI: 10.1016/S0140-6736(16)00339-1.
8 Hughes RA, Newsom-Davis JM, Perkin GD, et al. Controlled trial prednisolone in acute polyneuropathy[J]. Lancet, 1978, 2(8093): 750-753. PMID: 80682. DOI: 10.1016/s0140-6736(78)92644-2.
9 Hadden RD, Cornblath DR, Hughes RA, et al. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group[J]. Ann Neurol, 1998, 44(5): 780-788. PMID: 9818934. DOI: 10.1002/ana.410440512.
10 Wu XJ, Li CR, Zhang B, et al. Predictors for mechanical ventilation and short-term prognosis in patients with Guillain-Barré syndrome[J]. Crit Care, 2015, 19(1): 310. PMID: 26330143. PMCID: PMC4557605. DOI: 10.1186/s13054-015-1037-z.
11 Durand MC, Porcher R, Orlikowski D, et al. Clinical and electrophysiological predictors of respiratory failure in Guillain-Barré syndrome: a prospective study[J]. Lancet Neurol, 2006, 5(12): 1021-1028. PMID: 17110282. DOI: 10.1016/S1474-4422(06)70603-2.
12 Hasan I, Papri N, Hayat S, et al. Clinical and serological prognostic factors in childhood Guillain-Barré syndrome: a prospective cohort study in Bangladesh[J]. J Peripher Nerv Syst, 2021, 26(1): 83-89. PMID: 33555098. DOI: 10.1111/jns.12434.
13 Green C, Baker T, Subramaniam A. Predictors of respiratory failure in patients with Guillain-Barré syndrome: a systematic review and meta-analysis[J]. Med J Aust, 2018, 208(4): 181-188. PMID: 29490222. DOI: 10.5694/mja17.00552.
14 Doets AY, Verboon C, van den Berg B, et al. Regional variation of Guillain-Barré syndrome[J]. Brain, 2018, 141(10): 2866-2877. PMID: 30247567. DOI: 10.1093/brain/awy232.
15 孙瑞迪, 江军, 刘智胜. 运动神经传导阻滞与儿童吉兰-巴雷综合征不同亚型间的关系[J]. 中国当代儿科杂志, 2020, 22(9): 970-974. PMID: 32933628. PMCID: PMC7499442. DOI: 10.7499/j.issn.1008-8830.2003048.
16 Hu MH, Chen CM, Lin KL, et al. Risk factors of respiratory failure in children with Guillain-Barré syndrome[J]. Pediatr Neonatol, 2012, 53(5): 295-299. PMID: 23084721. DOI: 10.1016/j.pedneo.2012.07.003.
17 Walgaard C, Lingsma HF, Ruts L, et al. Prediction of respiratory insufficiency in Guillain-Barré syndrome[J]. Ann Neurol, 2010, 67(6): 781-787. PMID: 20517939. DOI: 10.1002/ana.21976.
18 Dimario FJJ, Edwards C. Autonomic dysfunction in childhood Guillain-Barré syndrome[J]. J Child Neurol, 2012, 27(5): 581-586. PMID: 22241710. DOI: 10.1177/0883073811420872.
19 Samadi M, Kazemi B, Golzari Oskoui S, et al. Assessment of autonomic dysfunction in childhood Guillain-Barré syndrome[J]. J Cardiovasc Thorac Res, 2013, 5(3): 81-85. PMID: 24252981. PMCID: PMC3825393. DOI: 10.5681/jcvtr.2013.018.
20 Chakraborty T, Kramer CL, Wijdicks EFM, et al. Dysautonomia in Guillain-Barré syndrome: prevalence, clinical spectrum, and outcomes[J]. Neurocrit Care, 2020, 32(1): 113-120. PMID: 31297663. DOI: 10.1007/s12028-019-00781-w.
21 DiCapua DB, Lakraj AA, Nowak RJ, et al. Relationship between cerebrospinal fluid protein levels and electrophysiologic abnormalities in Guillain-Barré syndrome[J]. J Clin Neuromuscul Dis, 2015, 17(2): 47-51. PMID: 26583489. DOI: 10.1097/CND.0000000000000091.
22 Davalos L, Nowacek D, Elsheikh B, et al. Cerebrospinal fluid protein level and mechanical ventilation in Guillain-Barré syndrome patients[J]. J Neuromuscul Dis, 2021, 8(2): 299-303. PMID: 33459659. DOI: 10.3233/JND-200581.

基金

武汉儿童医院院内科研项目资助(2021FE015)。

PDF(491 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/