| 王丽 陈会生△ 刘娟丽 王婷婷 李晓龙.糖尿病酮症酸中毒合并吉兰-巴雷综合征2 例临床分析[J].,2016,16(6):1101-1103 |
| 糖尿病酮症酸中毒合并吉兰-巴雷综合征2 例临床分析 |
| Clinical Features of Diabetic Ketoacidosis Associated with Guillain-BarréSyndrome in two Patients |
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| DOI： |
| 中文关键词: 糖尿病酮症酸中毒 吉兰-巴雷综合征 临床表现 脑脊液检查 肌电图 |
| 英文关键词: Diabetic ketoacidosis Guillain-Barré syndrome Clinical manifestations Electromyography Cerebrospinal fluid
examination |
| 基金项目:辽宁省科技攻关计划项目（2013225089） |
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| 中文摘要: |
| 目的：研究糖尿病酮症酸中毒(diabetic ketoacidosis, DKA)合并吉兰- 巴雷综合征（Guillain-Barré syndrome，GBS）的临床特
点，以探讨其临床表现、治疗、预后及发病机制。方法：回顾性分析2 例DKA合并GBS患者的病例资料，对其病史、临床表现、电
生理学、脑脊液改变、治疗进行总结。结果：2 例DKA 患者均急性起病，两例患者发病前1 周均有呼吸道感染史，尽管DKA 得到
了纠正，患者出现呼吸衰竭后被发现四肢力弱。肌电图提示周围神经损害。脑脊液示细胞蛋白分离。给予免疫球蛋白后，例1 在
出现肢体瘫痪后18 天恢复至正常，遗留有四肢末端麻木感，例2 在出现肢体瘫痪后1年肌力恢复正常。结论：DKA合并GBS 临
床少见，多发生在DKA 纠正后一周左右出现四肢迟缓性瘫痪，早期给予免疫球蛋白治疗，预后相对良好，目前发病机制尚不清
楚。 |
| 英文摘要: |
| Objective:To explore the clinical manifestations, diagnosis, treatment, prognosis and pathogenesis of diabetic
ketoacidosis (DKA) associated with Guillain-Barré Syndrome (GBS) in two patients.Methods:We reviewed the history, clinical
manifestations, electrophysiological characteristics, laboratory features of CSF and treatment of 2 patients with DKA and GBS.Results:Both of the two patients showed acute onset with respiratory tract infection history before a week. Although they recovered fromthe state
of diabetic ketoacidosis, they suffered the four limbs motor weakness after a week. Electromyography showed evidence of peripheral
neuropathy. Cerebrospinal fluid analysis showed albuminocytolgoic dissociation. Treatment with immunglobulin resulted in improved
prognosis of the patients. One patient had complete recovery from the motor paresis and loss of sensation in the lower extremities on the
eighteenth day, the other patient had complete recovery by a year after the onset of symptoms.Conclusion:DKA combined with GBS is
rare, and the outcome is favorable after immunglobulin treatment in the early stage of disease, but the etiology and pathogenesis of DKA
associated with GBS are unclear. |
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