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Electrophysiologic studies in the Guillain–Barré syndrome: Effects of plasma exchange and antibody rebound

机译:吉兰-巴雷综合征的电生理学检查:血浆置换和抗体反弹的影响

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AbstractNerve conduction studies (NCS) and antiperipheral nerve myelin antibody (A‐PNM Ab) titers were measured serially in 29 patients with Guillain‐Barré syndrome (GBS), of whom 21 were treated with plasmapheresis. Data were obtained from 3 to 6 days until 1 to 2 years after onset of symptoms. Within 3 to 6 days, mean NCS were abnormal. They improved some by 1 week and became maximally abnormal by 4 to 8 weeks, during which time A‐PNM Ab fell to low levels. In 5 patients plasmapheresed, A‐PNM Ab fell and then increased at 4 to 8 weeks, followed by significant deterioration of NCS (P= 0.01) compared with those without antibody rebound at 18 weeks. These results suggest that, in monophasic GBS, there may be two mechanisms of conduction dysfunction such as early paranodal retraction and later demyelination. In some patients plasmapheresed, A‐PNM Ab may rebound associated with further conduction dysfunction. These patients may benefit from further plas
机译:摘要对29例吉兰-巴利综合征(GBS)患者进行连续的神经传导检查(NCS)和抗周围神经髓鞘抗体(A-PNM Ab)滴度检测,其中21例接受血浆置换治疗。数据是在症状出现后 3 至 6 天至 1 至 2 年内获得的。在 3 至 6 天内,平均 NCS 异常。它们在 1 周时有所改善,并在 4 至 8 周时变得最大异常,在此期间 A-PNM 抗体降至低水平。在 5 例血浆置换患者中,A-PNM 抗体在 4 至 8 周时下降后升高,随后 NCS 显著恶化 (P= 0.01),而无抗体的患者在 18 周时出现反弹。这些结果表明,在单相GBS中,可能存在两种传导功能障碍机制,例如早期结旁回缩和晚期脱髓鞘。在一些血浆置换的患者中,A-PNM 抗体可能反弹,并伴有进一步的传导功能障碍。这些患者可能受益于进一步的 PLAS

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