Korelacija kliničkih i neurofizioloških nalaza sa kvalitetom života bolesnika sa dijabetesnom polineuropatijom

  • Zoran Vukojević Neurology Clinic, Clinical Center Banja Luka, Bosnia and Herzegovina
  • Tatjana Pekmezović Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ana Nikolić Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Stojan Perić Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ivana Basta Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ivan Marjanović Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Dragana Lavrnić Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/2597
Ključne reči: diabetic neuropathies||, ||dijabetesne neuropatije, neurophysiology||, ||neurofiziologija, quality of life||, ||kvalitet života, questionnaires||, ||upitnici,

Sažetak


Uvod/Cilj. Dijabetesna polineuropatija definiše se kao prisustvo kliničkih ili supkliničkih simptoma i/ili znakova oštećenja perifernih živaca kod bolesnika sa dijabetesom melitusom u nedostatku drugih uzroka periferne neuropatije. Cilj rada bio je da se proceni kvalitet života povezan sa zdravljem (HRQoL) kod bolesnika sa dijabetesnom polineuropatijom i njegova povezanost sa kliničkim i neurofiziološkim nalazom. Metode. U istraživanju je učestvovalo 60 bolesnika sa distalnom simetričnom senzorimotornom dijabetesnom polineuropatijom u sklopu dijabetesa melitusa tipa 2. Za objektivnu procenu kliničkog nalaza korišćene su sledeće skale: Medical Research Council strenth score (MRC skor), Inflammatory Neuropathy Cause and Treatment (INCAT) skala invalidnosti (za ruke i noge), INCAT senzorna skala, Hamiltonova skala depresivnosti i anksioznosti. Elektroneurografija (ENG) sprovedena je na motornom delu n. medianus-a i n. peroneus-a i na senzornom delu n. medianus-a i na n. suralis-u. Svi bolesnici popunili su srpsku verziju upitnika SF-36. Rezultati. Registrovano je blago do umereno sniženje kvaliteta života kod bolesnika sa dijabetesnom polineuropatijom, i to bez razlika u fizičkom i mentalnom domenu (p > 0,05). Starost bolesnika, MRC skor, INCAT skala invalidnosti i INCAT senzorna skala bile su u korelaciji sa rezultatima na SF-36 upitniku (p < 0,01). Bolesnici sa višim skorom anksioznosti i depresivnosti imali su značajno lošiju percepciju zdravlja za sve domene, za oba kompozitna skora i ukupni SF-36 skor (p < 0,01). Motorni i senzorni ENG parametri za n. medianus značajno su korelisali sa HRQoL (p < 0,05). Zaključak. Naši rezultati pokazuju blago do umereno sniženje kvaliteta života kod bolesnika sa dijabetesnom polineuropatijom. Kvalitet života kod ovih bolesnika je u značajnoj vezi sa starošću bolesnika, njihovom mišićnom snagom, stepenom invalidnosti, senzornim smetnjama, depresivnošću i anksioznošću. Elektrofiziološki nalaz za n. medianus značajno je povezan sa kvalitetom života kod bolesnika sa dijabetesnom polineuropatijom.

Reference

Report and recommendations of the San Antonio conference on diabetic neuropathy. Neurology 1988; 38(7): 1161−5.

Vinik A, Ullal J, Parson HK, Casellini CM. Diabetic neuropathies: clinical manifestations and current treatment options. Nat Clin Pract Endocrinol Metab 2006; 2(5): 269−81.

Barrett AM, Lucero MA, Le T, Robinson RL, Dworkin RH, Chap-pell AS. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med 2007; 8(Suppl 2): S50−62.

Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28(4): 956−62.

Ziegler D. Painful diabetic neuropathy: treatment and future as-pects. Diabetes Metab Res Rev 2008; 24(Suppl 1): 52−7.

Gooch CL, Weimer LH. The electrodiagnosis of neuropathy: ba-sic principles and common pitfalls. Neurol Clin 2007; 25(1): 1−28.

Dyck PJ, Karnes JL, Brien OP, Litchy WJ, Low PA, Melton LJ. The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for diagnosis and staged severity. Neurology 1992; 42(6): 1164−70.

Benbow SJ, Wallymahmed ME, MacFarlane IA. Diabetic peripheral neuropathy and quality of life. QJM 1998; 91(11): 733−7.

Wändell PE. Quality of life of patients with diabetes mellitus. An overview of research in primary health care in the Nordic countries. Scand J Prim Health Care 2005; 23(2): 68−74.

Bosić-Živanović D, Medić-Stojanoska M, Kovacev-Zavisić B. The quality of life in patients with diabetes mellitus type 2. Vojnosanit Pregl 2012; 69(10): 858−63.

Venkataraman K, Wee HL, Leow MK, Tai ES, Lee J, Lim SC, et al. Associations between complications and health-related quality of life in individuals with diabetes. Clin Endocrinol (Oxf) 2013; 78(6): 865−73.

daCosta DiBonaventura M, Cappelleri JC, Joshi AV. A longitudinal assessment of painful diabetic peripheral neuropathy on health status, productivity, and health care utilization and cost. Pain Med 2011; 12(1): 118−26.

Kleyweg RP, van der Meché FG, Schmitz PI. Interobserver agree-ment in the assessment of muscle strength and functional abilities in Guillain-Barré syndrome. Muscle Nerve 1991; 14(11): 1103−9.

Merkies IS, Schmitz PI, van der Meché FG, Samijn JP, van Doorn PA. Inflammatory Neuropathy Cause and Treatment (INCAT) group. Clinimetric evaluation of a new overall disability scale in immune mediated polyneuropathies. J Neurol Neurosurg Psychiatry 2002; 72(5): 596−601.

Merkies IS, Schmitz PI, van der Meché FG, van Doorn PA. Psy-chometric evaluation of a new sensory scale in immune-mediated polyneuropathies. Inflammatory Neuropathy Cause and Treatment (INCAT) Group. Neurology 2000; 54(4): 943−9.

Van Nes SI, Faber CG, Hamers RP, Harschnitz O, Bakkers M, Hermans MC, et al. Revising two-point discrimination assess-ment in normal aging and in patients with polyneuropathies. J Neurol Neurosurg Psychiatr 2008; 79(7): 832−4.

Sharma KR, Saadia D, Facca AG, Resnick S, Ayyar DR. Clinical and electromyographic deep tendon reflexes in polyneuropa-thy: diagnostic value and prevalence. Acta Neurol Scand 2009; 119(4): 224−32.

Hamilton M. Development of a rating scale for primary depres-sive illness. Br J Soc Clin Psychol 1967; 6(4): 278−96.

Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32(1): 50−5.

Tankisi H, Pugdahl K, Fuglsang-Frederiksen A, Johnsen B, Carvalho M, Fawcett PR, et al. Pathophysiology inferred from electro-diagnostic nerve tests and classification of polyneuropathies. Suggested guidelines. Clin Neurophysiol 2005; 116(7): 1571−80.

SF-36 Health Survey (Original version). Language Recalls. Available from: http://www.qualitymetric.com [accessed 2010April 04].

Lloyd A, Sawyer W, Hopkinson P. Impact of long-term complica-tions on quality of life in patients with type 2 diabetes not us-ing insulin. Value Health 2001; 4(5): 392−400.

Padua L, Saponara G, Ghirlannda G, Aprile R, Padua R, Pauri F. Health-related qualitiy of life in type 1 diabetic patients and in-fluence od peripheral nerve involvement. Neurol Sci 2001; 22(3): 239−45.

Wasserman LI, Trifonova EA. Quality of life and structure of neurosis-like symptomatology in persons with insulin-dependent diabetes mellitus. Int J Ment Health 2004; 33(3): 47−57.

Smide B, Lukwale J, Msoka A, Wikblad K. Self-reported health and glycaemic control in Tanzanian and Swedish diabetic pa-tients. J Adv Nurs 2002; 37(2): 182−91.

Merkies IS, Schmitz PI. Getting closer to patients: the INCAT Overall Disability Sum Score relates better to patients' own clinical judgement in immune-mediated polyneuropathies. J Neurol Neurosurg Psychiatr 2006; 77(8): 970−2.

Merkies IS, Schmitz PI, Meché FG, Samijn JP, Doorn PA. Quality of life complements traditional outcome measures in immune-mediated polyneuropathies. Neurology 2002; 59(1): 84−91.

Yoshida S, Hirai M, Suzuki S, Awata S, Oka Y. Neuropathy is associated with depression independently of health-related quality of life in Japanese patients with diabetes. Psychiatry Clin Neurosci 2009; 63(1): 65−72.

Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and de-pression, and sleep. J Pain Symptom Manage 2005; 30(4): 374−85.

Hänninen JA, Takala JK, Keinänen-Kiukaanniemi SM. Depression in subjects with type 2 diabetes. Predictive factors and relation to quality of life. Diabetes Care 1999; 22(6): 997−8.

Mitsonis C, Dimopoulos N, Psarra V. Clinical implications of an-xiety in diabetes. A critical review of the evidence base. Eur Psychiatr 2009; 24(Suppl 1): S526.

Ovayolu N, Akarsu E, Madenci E, Torun S, Ucan O, Yilmaz M. Clinical characteristics of patients with diabetic polyneuropa-thy: the role of clinical and electromyographic evaluation and the effect of the various types on the quality of life. Int J Clin Pract 2008; 62(7): 1019−25.

Meijer JW, Lange F, Links TP, Hoeven JH. Muscle fiber conduc-tion abnormalities in early diabetic polyneuropathy. Clin Neu-rophysiol 2008; 119(6): 1379−84.

Objavljeno
2015/04/24
Broj časopisa
Vol. 71 Br. 9 (2014)
Rubrika
Originalni članak