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目的 研究北京市和河北省格林 -巴利综合征 (GBS)的流行病学和临床特征。方法 采用强化病例监测的方法 ,于 1993～ 1994年对北京市 4个城区、2个县和河北省 3个县进行 GBS流行病学调查。结果 根据NINCDS标准 ,在调查期间确诊为 GBS者共 5 4例。 GBS农村和城市的发病率经年龄调整后分别为 0 .9/ 10万和0 .8/ 10万。发病年龄专率高峰见于 5 0～ 5 9岁。农村春夏季发病率高于秋冬季 ,二者差异具有统计学意义 (P<0 .0 5 ) ,上述指标在城市差别则不明显 (P=0 .98)。农村和城市患者分别于起病后平均在 4.3和 7.6 d无力症状达高峰 ,发病后分别于 11.8和 17.5 d开始恢复 ,12个月随访时 79.2 %患者完全恢复 ,病死率分别为 8.6 %和 5 .3%。北京两县 19例患者的电生理检查结果表明 ,17例 (89.5 % )有脱髓鞘病变 ,10例 (5 2 .6 % )同时伴不同程度的轴索损伤 ,只有 1例 (5 .3% )以轴索病变为主。 2例患者的周围神经活检结果表明 ,病变以脱髓鞘为主。结论 北京和河北GBS的流行病学和临床特征与世界其他国家和地区相仿 ,分型以脱髓鞘型 GBS为主
Objective To study the epidemiological and clinical features of Guillain-Barre Syndrome (GBS) in Beijing and Hebei Province. Methods The method of intensified case surveillance was used to carry out GBS epidemiological investigation in 4 urban districts, 2 counties and 3 counties in Hebei Province from 1993 to 1994. Results According to the NINCDS standard, 54 cases were diagnosed as GBS during the survey. The incidence of GBS in rural and urban areas was adjusted to be 0.9 / 100,000 and 0.8 / 100,000 respectively after being age-adjusted. The peak age of onset of incidence seen in 50 ~ 59 years old. The incidence of spring and summer in rural areas was higher than that in autumn and winter, the difference was statistically significant (P <0.05). The above indexes were not obvious in cities (P = 0.98). In rural and urban areas, the average symptom onset peaked at 4.3 and 7.6 days after onset, respectively, and recovered at 11.8 and 17.5 days respectively after onset. At the 12-month follow-up, 79.2% of the patients recovered completely with a mortality of 8.6% and 5% respectively .3%. The results of electrophysiological examination in 19 patients in two counties of Beijing showed that there were 17 cases (89.5%) with demyelinating lesions, 10 cases (52.6%) with axonal injuries of different degrees and only 1 case (5.3 %) Axonal lesions based. Peripheral nerve biopsy results of 2 patients showed that the lesions were mainly demyelinating. Conclusions The epidemiological and clinical features of GBS in Beijing and Hebei are similar to those in other countries and regions in the world. The typing is based on demyelinating GBS