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目的探讨血浆置换(plasma exchange,PE)或静脉用丙种球蛋白(intravenous immunoglobulin,IVIG)治疗急性吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)的近期疗效及安全性。方法 36例急性GBS患者随机分为2组各18例,PE组在营养神经、早期康复干预、呼吸机辅助呼吸、对症支持等常规治疗基础上给予PE治疗,IVIG组在常规治疗基础上给予IVIG静脉滴注,比较2组治疗前,治疗后1,7,14d及1,6个月Hughes评分,治疗前、治疗后7d血浆IgG、IgA、IgM、补体C3、C4及总蛋白水平。结果 2组治疗后7d血浆补体C3,C4及免疫球蛋白IgG,IgA,IgM水平及治疗后14d及1,6个月Hughes评分均较治疗前下降(P<0.05或P<0.01);2组治疗后各指标水平及各时间点Hughes评分比较差异均无统计学意义(P>0.05)。结论 PE及IVIG均是治疗急性GBS安全有效地方法。
Objective To investigate the short-term efficacy and safety of plasma exchange (PE) or intravenous intravenous immunoglobulin (IVIG) in the treatment of acute Guillain-Barre syndrome (GBS). Methods Thirty-six patients with acute GBS were randomly divided into two groups (n = 18). The PE group was given PE on the basis of conventional treatment such as nutrition nerve, early rehabilitation intervention, ventilator assisted breathing and symptomatic support. The IVIG group was given IVIG The levels of IgG, IgA, IgM, C3, C4 and total protein in the two groups before treatment, 1, 7, 14 and 1, 6 months after treatment were compared before and after treatment. Results The levels of serum C3, C4 and immunoglobulin IgG, IgA and IgM in the two groups after treatment were significantly lower than those before treatment (P <0.05 or P <0.01) After treatment, the levels of each index and Hughes score at each time point showed no significant difference (P> 0.05). Conclusion Both PE and IVIG are safe and effective in the treatment of acute GBS.