GBS 总体预后良好,约 85% 的幸存者功能恢复良好。研究显示,使用机械通气的患者死亡率为 20%。[144]Fletcher DD, Lawn ND, Wolter TD, et al. Long-term outcome in patients with GBS requiring mechanical ventilation. Neurology. 2000;54:2311-2315.http://www.ncbi.nlm.nih.gov/pubmed/10881259?tool=bestpractice.com
老年患者预后较差。[24]Hadden RD, Karch H, Hartung HP, et al. Preceding infections, immune factors, and outcome in Guillain-Barré syndrome. Neurology. 2001;56:758-765.http://www.ncbi.nlm.nih.gov/pubmed/11274311?tool=bestpractice.com[58]Guillain-Barré Syndrome Study Group. Guillain-Barré syndrome: an Italian multicentre case-control study. Neurol Sci. 2000;21:229-234.http://www.ncbi.nlm.nih.gov/pubmed/11214662?tool=bestpractice.com与不良预后相关的因素包括严重无力、起病急、年老、肌肉萎缩、电刺激神经无反应及之前患有腹泻。[1]Hadden RD, Hughes RA. Management of inflammatory neuropathies. J Neurol Neurosurg Psychiatry. 2003;74(suppl 2):ii9-ii14.http://jnnp.bmj.com/content/74/suppl_2/ii9.longhttp://www.ncbi.nlm.nih.gov/pubmed/12754323?tool=bestpractice.com米勒-费雪综合征的预后比其他 GBS 亚型好。发现大部分急性运动轴索性神经病重度残疾患者均可以在几年内独立行走。[2]Hiraga A, Mori M, Ogawara K, et al. Recovery patterns and long term prognosis for axonal Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2005;76:719-722.http://jnnp.bmj.com/content/76/5/719.longhttp://www.ncbi.nlm.nih.gov/pubmed/15834034?tool=bestpractice.com大部分预后不良的患者有机械通气史。已证实这些患者的死亡率为 20%。[144]Fletcher DD, Lawn ND, Wolter TD, et al. Long-term outcome in patients with GBS requiring mechanical ventilation. Neurology. 2000;54:2311-2315.http://www.ncbi.nlm.nih.gov/pubmed/10881259?tool=bestpractice.com重症疾病的恢复期可能延长,但大部分患者可以独立行走。[144]Fletcher DD, Lawn ND, Wolter TD, et al. Long-term outcome in patients with GBS requiring mechanical ventilation. Neurology. 2000;54:2311-2315.http://www.ncbi.nlm.nih.gov/pubmed/10881259?tool=bestpractice.com急性和长期残疾似乎与轴索损伤有关,且疾病最严重时 Hughes 评分≥2。[145]Chio A, Cocito D, Leone M, et al. Guillain-Barré Syndrome: a prospective, population-based incidence and outcome survey. Neurology. 2003;60:1146-1150.http://www.ncbi.nlm.nih.gov/pubmed/12682322?tool=bestpractice.com