Prezentacija bolova kod obolelih od sistemske skleroze
Sažetak
Sažetak:
Uvod: Sistemska skleroza (SSc) je hronično autoimunsko oboljenje koje odlikuje heterogenost kliničkih manifestacija. Ne postoji značajan broj istraživanja fokusiran na bolove koji se javljaju kod obolelih od SSc.
Cilj rada: Ispitivanje učestalosti i jačine bolova kod bolesnika sa sistemskom sklerozom u odnosu na oblik bolesti (difuzni i limitirani) i prisustvo anticentromernih antitela i antitela na topoizomerazu-I (ACA i ATA).
Pacijenti i metode: Istraživanje je obuhvatilo 42 bolesnika sa dijagnostikovanom sistemskom sklerozom, koji su anketirani u Institutu za reumatologiju u Beogradu. Na osnovu ankete dobijeni su podaci o učestalosti, lokalizaciji i i intenzitetu bola. Za analizu podataka korišćene su metode deskriptivne i analitičke statistike.
Rezultati: Bolovi različite vrste postoje kod 39 (93%) ispitanika. Artralgija je najčešći bol, koji trpi 33 (78,6%) obolelih, zatim bol u toku epizoda Raynaud-ovog fenomena u 29 (69%), bol u ledjima je jedan od češćih koji je imalo 20 (47,6%) ispitanika. Glavobolja je bila prisutna kod 13 (31%), bol u grudima javljao se kod 10 (23,8%), odinofagija kod 9 (21,4%) i bol uled ranica na prstima šaka kod 8 (19%) ispitanika. Najintenzivnijim je ocenjen bol zbog prisustva ulceracija sa prosečnom ocenom 8,5/10. Bolesnici sa difuznom sistemskom sklerozom u proseku su imali jače bolove u zglobovima (7,6) od bolesnika sa ograničenim oblikom bolesti (5,5). U odnosu na prisustvo anticentromernih i antitela na topoizomerazu-I nije pronadjena statistički značajna razlika u učestalosti i intenzitetu bola.
Zaključak: Većina bolesnika trpi neku vrstu bola, najčešće su to bolovi u zglobovima, a najjači usled ranica na prstima iako su oni kod ispitanika bili najredji. Ne postoji razlika u učestalosti i jačini bolova u odnosu na prisustvo antitela na topoizomerazu-I i anticentromernih antitela. Bolesnici sa difuznom sistemskom sklerozom su imali značajno jače bolove u zglobovima u odnosu na obolele od ograničenog oblika bolesti.
Ključne reči: sistemska skleroza, bol, autoantitela.
Abstract:
Introduction: Systemic sclerosis (SSc) is a chronic autoimmune disease with very heterogeneous clinical manifestations. There are not many studies which directly research the pain experienced by patients with SSc.
Aim of study: Evaluation of pain in patients with verified systemic sclerosis; making comparison in the two subsets of SSc (diffuse and limited) and in the anti-centromere antibodies (ACA) and anti-topoisomerase-I antibodies (ATA) detected in patients.
Patients and methods: The study group included 42 patients with SSc. The research was conducted at the Institute of Rheumatology in Belgrade. Each patient was asked to complete the questionnaire which included the questions about frequency, location and intensity of the pain. Two statistical methodologies were used in the data analysis: descriptive and analytical statistics.
Results: Most of the patients (93%) confirmed they had pain of some kind. Arthralgia was the most common pain symptom (78,6%), 29 (69%) suffered from pain during Raynad phenomenon, the back pain was found in 20 (47,6%), a headache in 13 (31%), the chest pain in 10 (23,8%), odynophagia in 9 (21,4%) and in 8 (19%) patients painful digital ulcers. The pain from digital ulcers was rated as the most intensive with the average value 8,5/10. The patients with diffuse subset of SSc had a higher average intensity score of arthralgia (7,6) compared to those with limited SSc (5,5). The statistically significant difference in the frequency and intensity of the pain in the patients with anti-topoisomerase-I antibodies and the patients with anti-centromere antibodies was not found.
Conclusion: Most of the patients suffer from some kind of pain. The most common pain was arthralgia and the most intensive one was from digital ulcers although it was the rarest. The pain frequency and intensity were not significantly different in the patients with anti-topoisomerase-I and anti-centromere antibodies. There was a statisticaly significant difference in the average value of arthralgia intensity between the patients with diffuse and the patients with limited SSc.
Key words: systemic sclerosis, pain, autoantibodiesReference
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