儿童吉兰-巴雷综合征交感皮肤反应的特点分析

Characteristics of sympathetic skin response in children with Guillain-Barré syndrome

摘要:

目的 探讨交感皮肤反应（sympathetic skin response, SSR）对儿童吉兰-巴雷综合征（Guillain-Barré syndrome, GBS）早期诊断及预后评估的价值。方法 回顾性收集2018年10月—2022年11月收治的25例GBS患儿的临床资料，选取同期诊断为抽动障碍的30例患儿作为对照组，比较两组患儿间SSR的特点，并分析SSR与自主神经功能障碍（autonomic dysfunction, AD）、疾病严重程度及预后的关系。结果 GBS组患儿急性期SSR异常率高于对照组（P<0.001）。联合SSR和神经传导早期（发病2周内）诊断GBS的灵敏度、特异度和准确度分别为84％、100％和93％。SSR异常患儿AD比例及疾病高峰时Hughes评分与SSR正常患儿比较差异均无统计学意义（P>0.05）。短期（发病1个月）预后不良患儿SSR测定全部（7/7）异常。结论 SSR可以用于早期辅助诊断儿童GBS和监测疾病治疗情况。

Abstract:

Objective To explore the value of sympathetic skin response (SSR) in the early diagnosis and prognostic evaluation of Guillain-Barre syndrome (GBS) in children.Methods A retrospective analysis was conducted on the clinical data of 25 children with GBS who were diagnosed from October 2018 to November 2022, and 30 children who were diagnosed with Tourette's syndrome during the same period were selected as the control group. The characteristics of SSR were compared between the two groups, and the association of SSR with autonomic dysfunction (AD), disease severity, and prognosis was analyzed.Results The GBS group had a significantly higher abnormal rate of SSR than the control group during the acute phase (P<0.001). SSR combined with early nerve conduction (within 2 weeks after onset) had a sensitivity of 84%, a specificity of 100%, and an accuracy of 93% in the diagnosis of GBS. There were no significant differences in the proportion of AD cases, as well as the Hughes scores during the disease peak, between the abnormal and normal SSR groups (P>0.05). All 7 children with poor short-term prognosis (at 1 month after onset) had abnormal SSR.Conclusions SSR can be used for the early diagnosis of GBS and the monitoring of treatment response in children.