现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
14期
2109-2110,2112
,共3页
ADH分泌不当综合征%低钠血症%格林-巴利综合征%疾病特征%Meta分析
ADH分泌不噹綜閤徵%低鈉血癥%格林-巴利綜閤徵%疾病特徵%Meta分析
ADH분비불당종합정%저납혈증%격림-파리종합정%질병특정%Meta분석
Inappropriate ADH syndrome%Hyponatremia%Guillain-Barre syndrome%Disease attributes%Meta-Analysis
目的：总结以抗利尿激素分泌不当综合征（SIADH）为首发表现的吉兰-巴雷综合征（GBS）的临床特征和诊治情况。方法检索国内外1980~2014年发表的以SIADH为首发表现的GBS病例报道，对纳入病例进行分析，探讨其临床特点。结果共纳入4例病例，均为女性，发病年龄38~82岁，中位年龄62.5岁。初期表现为精神状态改变（100%）、头痛（50%）、疲乏（50%）、背痛（50%）、呼之不应（25%）、呕吐（25%）等，查体常无明显神经系统损伤定位体征（75%）。发病至GBS典型症状出现时间3~15 d，中位时间5 d。结论该病发病机制尚未明确，病情较重、诊断困难。明确诊断后，治疗反应可，预后好。需行肿瘤筛查，排除副肿瘤综合征可能。
目的：總結以抗利尿激素分泌不噹綜閤徵（SIADH）為首髮錶現的吉蘭-巴雷綜閤徵（GBS）的臨床特徵和診治情況。方法檢索國內外1980~2014年髮錶的以SIADH為首髮錶現的GBS病例報道，對納入病例進行分析，探討其臨床特點。結果共納入4例病例，均為女性，髮病年齡38~82歲，中位年齡62.5歲。初期錶現為精神狀態改變（100%）、頭痛（50%）、疲乏（50%）、揹痛（50%）、呼之不應（25%）、嘔吐（25%）等，查體常無明顯神經繫統損傷定位體徵（75%）。髮病至GBS典型癥狀齣現時間3~15 d，中位時間5 d。結論該病髮病機製尚未明確，病情較重、診斷睏難。明確診斷後，治療反應可，預後好。需行腫瘤篩查，排除副腫瘤綜閤徵可能。
목적：총결이항이뇨격소분비불당종합정（SIADH）위수발표현적길란-파뢰종합정（GBS）적림상특정화진치정황。방법검색국내외1980~2014년발표적이SIADH위수발표현적GBS병례보도，대납입병례진행분석，탐토기림상특점。결과공납입4례병례，균위녀성，발병년령38~82세，중위년령62.5세。초기표현위정신상태개변（100%）、두통（50%）、피핍（50%）、배통（50%）、호지불응（25%）、구토（25%）등，사체상무명현신경계통손상정위체정（75%）。발병지GBS전형증상출현시간3~15 d，중위시간5 d。결론해병발병궤제상미명학，병정교중、진단곤난。명학진단후，치료반응가，예후호。수행종류사사，배제부종류종합정가능。
Objective To summarize the clinical characteristics and management of Guillain-Barre syndrome(GBS) with syndrome of inappropriate antidiuretic hormone(SIADH) as the initial presentation. Methods A systematic retrieval of GBS with SIADH as the initial presentation in 1980-2014 was performed. The patients in the study were analyzed to explore the clinical characteristics. Results All the 4 patients were females,and the age of onset was from 38 to 82 years old with a median age of 62.5 years. The main symptoms and signs in the early stages of disease included altered mental status (100%),headache (50%),malaise(50%),back pain(50%),no response to voice(25%),vomiting(25%) and so on. Physical examination showed that nervous system impairment had no obvious locating features (75%). The interval time between the onset and the day on which typical symptoms of GBS appeared,varied from 3 to 15 d,with a median time of 5 d. Conclusion Pathogenesis of this disease is still not clear,it often appears with severe and complicated clinical situations,which is difficult to diagnose. Malignant tumor screening is needed to exclude the possibility that paraneoplastic syndrome.
