Neuropatski bol kao nezavisan prediktor lošijeg kvaliteta života kod bolesnika sa dijabetesnom neuropatijom

  • Zoran Vukojević University of Banja Luka, Faculty of Medicine, University Clinical Centre of Republic of Srpska, Clinic for Neurology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Stojan Perić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Aleksandra Dominović Kovačević University of Banja Luka, Faculty of Medicine, University Clinical Centre of Republic of Srpska, Clinic for Neurology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Ivo Božović University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Sanja Grgić University of Banja Luka, Faculty of Medicine, University Clinical Centre of Republic of Srpska, Clinic for Neurology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Ivana Basta University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Dragana Lavrnić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP181010017V
Ključne reči: anksioznost, depresija, dijabetesne neuropatije, neuralgija, kvalitet života, faktori rizika, ankete i upitnici

Sažetak


Uvod/Cilj. Prevalenca šećerne bolesti u opštoj populaciji raste. Sa druge strane, veliki je broj obolelih od dijabetesa sa neuropatskim bolom. Cilj studije je bio da se ispita uticaj neuropatskog bola na kvalitet života kod bolesnika sa dijabetesnom senzorimotornom polineuropatijom (DSPN), koji nisu imali ni jednu drugu dijabetesnu komplikaciju niti bilo kakve druge komorbiditete od značaja. Metode. Ukupno 32 bolesnika sa DPN i definitivnim prusustvom neuropatskog bola su upoređivani sa 32 bolesnika sa DSPN bez neuropatskog bola. Ispitanici su bili upareni po polu, starosti i trajanju bolesti. Korišćene su sledeće skale: Pain Detect Questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropatathique EN 4 Question, Hamiltonova skala depresivnosti i anksioznosti, Neuropathy Impairment Score of the Lower Limb (NIS-LL) i Short Form 36 Health Survey Questionnaire  (SF-36). Rezultati. Bolesnici sa neuropatskim bolom su imali znatno težu DSPN mereno pomoću NIS-LL (p < 0,01). Bolesnici sa neuropatskim bolom su se češće bavili fizičkim poslovima (p < 0,05) i češće su imali simptome i depresije (p < 0,05) u odnosu na bolesnike bez neuropatskog bola. Bolesnici sa neuropatskim bolom su imali značajno lošiji kvalitet života, kako u fizičkim, tako i u mentalnim domenima (p < 0,01). Nezavisni prediktori lošijeg kvaliteta života kod bolesnika sa DSPN su bili: prisustvo depresije (beta = -0,58, p < 0,01) i prisustvo neuropatskog bola (beta = -0,23, p < 0,05) – pilagođeno R2 = 0,4. Zaključak. Nezavisni prediktori lošijeg kvaliteta života kod bolesnika sa DSPN bili su prisustvo depresije i neuropatskog bola, što ukazuje na značaj njihovog ranog prepoznavanja i ranog lečenja.

Reference

Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, et al. Redefinition of neuropathic pain and a grad-ing system for clinical use: consensus statement on clinical and research diagnostic criteria. Neurology 2008; 70(18): 1630–5.

Haanpää M, Treede R. Diagnosis and classification of neuro-pathic pain. Pain 2010; 18(7): 1−6.

Griebeler ML, Morey-Vargas OL, Brito JP, Tsapas A, Wang Z, Carranza Leon BG, et al. Pharmacologic interventions for painful diabetic neuropathy: an umbrella systematic review and comparative effectiveness network meta-analysis. Ann In-tern Med 2014; 161(9): 639−49.

International Diabetes Federation. IDF diabetes atlas 2014. Available from: www.idf.org/diabetesatlas.

Centers for Disease Control and Prevention. National Diabetes Sta-tistics Report: Estimates of Diabetes and its Burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014. Available at: cdc.gov/diabetes/data/statistics/2014statisticsreport.

Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropa-thy: epidemiology, pain description, and quality of life. Diabe-tes Res Clin Pract 2000; 47(2): 123−8.

Van Acker K, Bouhassira D, De Bacquer D, Weiss S, Matthys K, Raemen H, et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpa-tients clinics. Diabetes Metab 2009; 35(3): 206−13.

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.

Aslam A, Singh J, Rajbhandari S. The impact of painful diabetic neuropathy on quality of life: an observational study. Prim Care Diabetes 2014; 16(4): 212−9.

Dermanovic Dobrota V, Hrabac P, Dinko Skegro D, Smiljanic R, Dobrota S, Prkacin I, et al. The impact of neuropathic pain and other comorbidities on the quality of life in patients with dia-betes. Health Qual Life Outcomes 2014; 12: 171.

Haanpää M, Attal N, Backonja M, Baron R, Bennet M, Bouhassira D, et al. NeuPSIG guidelines on neuropathic pain assessment. Pain 2011; 152(1): 14−27.

Dyck P, Albers JA, Andersen H, Arezzo JC, Biessels GJ, Bril V, et al. Diabetic polyneuropathies: update on research defini-tion, diagnostic criteria and estimation of severity. Diabetes Metab Res Rev 2011; 27(7): 620–8.

Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic compo-nents in patients with back pain. Curr Med Res Opin 2006; 22(10): 1911–20.

Bennet MI. The LANSS pain scale: the Leeds assessment af neuropathic symptoms and signs. Pain 2001; 92(1−2): 147−57.

Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nerv-ous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005; 114(1−2): 29–36.

Dyck PJ, Hughes RAC, O'Brien PC. Quantitating overall neu-ropathic symptoms, impairments, and outcomes. In: Dyck PJ, Thomas PK, editors. Peripheeral Neuropathy Philadelphia, PA: Elsevier; 2005; p. 1031−52.

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.

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

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.

Vukojevic Z, Pekmezovic T, Nikolic A, Perić S, Basta I, Marjanović I, et al. Correlation of clinical and neurophysiological findings with health-related quality of life in patients with diabetic polyneuropathy. Vojnosanit Pregl 2014; 71(9): 833−8.

Kulkantrakom K, Lorsuwansiri C. Sensory profile and its impact on quality of life in patients with painfufl diabetic polyneu-ropathy. J Neurosci Pract 2013; 4(3): 267−70.

Grau-López L, Sierra S, Martínez-Cáceres E, Ramo-Tello C. Analysis of the pain in multiple sclerosis patients. Neurologia 2011; 26(4): 208−13.

Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, et al. Dutch GBS Study Group. Pain in Guillain-Barre syn-drome: a long-term follow-up study. Neurology 2010; 75(16): 1439−47.

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.

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

Lyracos G, Hastziagelaki E, Damigos D, Papazafiropoulou A, Bousboulas S, Batistaki C. Predictors of health-related quality of life in diabetic neuropathy type II diabetic patients in Greece. Health Sci J 2013; 7(3): 327−41.

Papadopoulos A, Kontodimopoulos N, Frydas A, Ikonlmakis E, Niakas D. Predictors of health-related quality of life in type II diabetic patients in Greece. BMC Public Health 2007; 7: 186.

Wändell P. Quality of life of patients with diabetes mellitus. Scand J Prim Health Care 2005; 23(2): 68−74.

Objavljeno
2021/10/01
Broj časopisa
Vol. 78 Br. 9 (2021): Vojnosanitetski pregled
Rubrika
Originalni članak