Mineralna koštana gustina u poređenju sa antropometrijskim parametrima i stepenom oštećenja grube motoričke funkcije kod dece sa cerebralnom paralizom

  • Jelena Zvekić Svorcan University of Novi Sad, Faculty of Medicine Novi Sad, Serbia;Special Hospital for Rheumatic Diseases Novi Sad, Serbia
  • Mirjana Stojšić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Rastislava Krasnik University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Nataša Nenadov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia Home „Veternik“, Veternik, Serbia
  • Čila Demeši Drljan University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Home „Veternik“, Veternik, Serbia
  • Aleksandra Mikov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Special Hospital for Rheumatic Diseases, Novi Sad, Serbia
  • Maja Radovanov Health Center „Novi Sad“, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP170508125Z
Ključne reči: paraliza, cerebralna;, deca;, antropometrija;, kost, gustina;, mišići, tonus.

Sažetak


Uvod/Cilj. Deca sa cerebralnom paralizom (CP) rastu sporije u odnosu na svoje vršnjake. Njihova telesna visina, telesna težina i mineralna koštana gustina značajno su niže u odnosu na opštu populaciju zdrave dece. Cilj ovog rada bio je procena mineralne koštane gustine u odnosu na antropometrijske parametre i nivo grube motoričke funkcije kod dece sa CP. Metode. Pilot sudija preseka obuhvatila je 23 dece sa CP, uzrasta od 6 do 17 godina, motoričkog nivoa procenjenog prema sistemu klasifikacije grubih motornih funkcija (The gross motor function classification system-expanded and revised – GMFCS-E&R) i antropometrijskih parametara pre­ma kartama razvoja za zdravu decu, kao i prema kartama razvoja za decu sa cerebralnom paralizom. Mineralna koš­tana gustina merena je dvostrukom X-zračnom apsor­pcio­metrijom, a za očitavanje nalaza korišćene su preporuke Internacionalnog udruženja kliničke denzitometrije – The International Society for Clinical Densitometry Official Positions of Adults & Pediatrics. Od deskriptivnih statističkih mera ko­rišćena je srednja vrednost sa interkvartilnim odstupanjima, frekvencije i procenti. Razlike između grupa procenjivane su Kruskal-Wallis-ovim testom. Rezultati. U uzorku od 23 dece, bilo je 56,5% dečaka i 43,5% devojčica, starosne dobi 13,00 ± 3,56 godina. Njih 4/5 je imalo teži oblik motoričke onesposobljenosti (GMFCS-E&R, nivoi IV i V ). Naši ispitanici imali su nižu koštanu gustinu na obe posmatrane regije [Z-skor kičme -1,60 ± 1,40 standardne devijacije (SD); Z-skor kuka -2,00 ± 3,00 SD], kao i niže antropometrijske parametre [Z-skor telesne visine –2,74 ± 4,28; Z-skor te­lesne mase -3,22 ± 6,96, Z-skor indeksa telesne mase (BMI) -2,64 ± 6,03]. U posmatranom uzorku kod svih ispitanika bila je snižena mineralna koštana gustina na kičmi (p < 0,01) i na kuku (p < 0,05), a svi su imali nižu telesnu masu (p < 0,01) i BMI (p < 0,01), ali ne i telesnu visinu u odnosu na postojeće karte razvoja dece sa CP (SAD). Deca sa CP nivo IV GMFCS-E&R imala su značajno manju koštanu gu­stinu ( Z-skor kičme -1,90 SD, Z-skor kuka -3,40 SD), dok kod nivoa V sniženje je bilo još izraženije ( Z-skor kičme -3,80 SD, Z-skor kuka -2,30 SD). Zaključak. Deca sa CP imala su značajno manju vrednost mineralne koštane gusti­ne kao i svih posmatranih antropometrijskih parametara. U posmatranom uzorku kod svih ispitanika bila je snižena mineralna koštana gustina na kičmi i na kuku, a svi su imali nižu telesnu masu i BMI, ali ne i telesnu visinu u odnosu na postojeće karte razvoja dece sa CP (SAD). Deca sa težim oblicima CP (GMFCS-E&R, nivoi IV i V stepen) imala su značajno manju vrednost mineralne koštane gustine.

Biografije autora

Jelena Zvekić Svorcan, University of Novi Sad, Faculty of Medicine Novi Sad, Serbia;Special Hospital for Rheumatic Diseases Novi Sad, Serbia

MD;MSc Teaching assistant

Mirjana Stojšić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

MD;PhD

Rastislava Krasnik, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

MD;PhD Assistant professor

Nataša Nenadov, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia Home „Veternik“, Veternik, Serbia

MD;MSc Teaching assistant

Čila Demeši Drljan, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Home „Veternik“, Veternik, Serbia

MD;PhD Assistant professor

Aleksandra Mikov, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Special Hospital for Rheumatic Diseases, Novi Sad, Serbia

MD;PhD Full professor

Maja Radovanov, Health Center „Novi Sad“, Novi Sad, Serbia

MD; MSc

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2021/02/12
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Vol. 76 Br. 5 (2019): Vojnosanit pregl
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Originalni članak