摘要：

目的: 报道3例热射病致吉兰-巴雷综合征并进行文献复习，总结热射病致吉兰-巴雷综合征的临床特征。方法与结果: 共3例患者均为南昌大学第二附属医院2022年8月诊断与治疗病例，临床主要表现为热射病意识障碍恢复后四肢无力、构音障碍，体格检查腱反射消失，肌电图提示广泛性周围神经损害，以轴索损害为主，运动神经受累为著，其中例1和例2存在脑脊液蛋白细胞分离现象，临床诊断为热射病致吉兰-巴雷综合征，予免疫治疗后肌力较前好转，但1年余随访时仍遗留明显神经功能障碍。结论: 热射病致吉兰-巴雷综合征病情危重，多发生于热射病3周内，免疫治疗后肌力不同程度改善，但仍遗留严重神经功能缺损，预后较差。

关键词: 中暑, 格林-巴利综合征, 肌电描记术, 免疫疗法

Abstract:

Objective: To report 3 cases of Guillain-Barré syndrome (GBS) caused by heat stroke (HS) and review the relevant literatures, and summarize the clinical characteristics of GBS caused by HS. Methods and Results: The three patients were all diagnosed and treated by The Second Affiliated Hospital of Nanchang University in August 2022. The clinical manifestations were mainly weakness of limbs and dysarticulation after recovery of consciousness disorder of HS, disappearance of tendon reflex as shown by physical examination, extensive peripheral nerve damage mainly caused by axonal damage and motor nerve involvement as shown by EMG. Cerebrospinal fluid protein cell segregation phenomenon was present in Case 1 and Case 2, and the clinical diagnosis was GBS caused by HS. The muscle strength was better than before after immunotherapy, but obvious neurological dysfunction was still found after one year follow-up. Conclusions: GBS caused by HS is a severe condition, often appearing within 3 weeks after HS. Immunotherapy leads to varying degrees of improvement in muscle strength; however, significant neurological dysfunction still persist, resulting in a poorer prognosis compared to general GBS.

Key words: Summer heat stroke, Guillain-Barre syndrome, Electromyography, Immunotherapy

中图分类号: 

• 中暑

• 格林-巴利综合征

• 肌电描记术

• 免疫疗法

• Summer heat stroke

• Guillain-Barre syndrome

• Electromyography

• Immunotherapy