FAKTORI RIZIKA ZA POJAVU ONIHOMIKOZA I KLASTER ANALIZA
Sažetak
Definisanje različitih fenotipova bolesti na osnovu kliničkih parametara predstavlja trend u istraživanjima sprovedenim poslednjih godina. Klaster analiza je statistička metoda za kategorizaciju različitih kliničkih znakova i simptoma na osnovu stepena njihove povezanosti.
Ovaj rad je za cilj imao da ispita mogućnost primene klaster analize za klasifikaciju različitih kliničkih fenotipova onihomikoze i određivanje faktora rizika za nastanak ove infekcije.
U ovoj prospektivnoj studiji korišćeni su podaci dobijeni posebno dizajniranim upitnikom u vezi sa površinskim gljivičnim infekcijama kože i adneksa. Upitnik se sastojao od tri grupe pitanja, koje su obuhvatale demografske podatke, simptome i kliničke znake, kao i faktore rizika. U statističkoj obradi podataka korišćena je hijerarhijska metoda klaster analize, Vordova metoda sa euklidskom distancom.
Primenjenom statističkom metodom bolesnici su podeljeni u dva klastera. Prvi klaster činili su bolesnici sa onihomikozom noktiju na stopalima, praćenom bolom, potpunim uništenjem nokatne ploče, zahvaćenošću 2/3 nokta i zadebljanjem nokta većim od 2 mm. Drugi klaster koji su činili bolesnici sa onihomikozom noktiju na šakama, dalje je podeljen na dva potklastera. Prvi je uključivao bolesnike sa lezijama korena nokta, unutrašnjosti nokta, površinskim promenama i zahvaćenom kožom oko nokta. Drugi potklaster obuhvatao je bolesnike kod kojih su uočeni zadebljanje nokatne ploče do 1 mm, promene slobodne ivice, zahvaćenost do 1/3 nokta i lomljivost nokta. Utvrđeno je da su najčešći faktori rizika bili gojaznost (50%), pozitivna porodična anamneza (32,0%), trauma nokatne ploče (15,0%) i dugotrajna terapija antibioticima (11,0%).
Fenotipizacija infekcije i njeno razmatranje uz najzastupljenije faktore rizika za onihomikozu mogu u velikoj meri poboljšati procenu i dijagnozu bolesti.
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