Učestalost različitih formi neuropatija kod obolelih od sistemskih bolesti vezivnog tkiva: klinička i elektrofiziološka studija
Sažetak
Uvod/Cilj. Periferna neuropatija (PN) u sistemskim bolestima vezivnog tkiva (SBVT) predstavlja jasnu komplikaciju bolesti ili inicijalnu manifestaciju klinički nedijagnostikovane bolesti. Cilj rada bio je da se odrede tipovi i procenat zastupljenosti neuropatija (N), ukaže na dijagnostički značaj pojedinih elektrofizioloških (EF) parametara kod bolesnika sa reumatoidnim artritisom (RA), sistemskim eritemskim lupusom (SLE) i sistemskom sklerozom (SSc) i utvrdi njihova povezanost sa aktivnošću bolesti (AB) i dužinom trajanja bolesti (DTB). Metode. Istraživanje je obavljeno u formi prospektivne studije na Klinici za reumatologiju Instituta za lečenje i rehabilitaciju „Niška Banja” u trajanju od tri godine. U istraživanje je bilo uključeno ukupno 157 bolesnika, od kojh je 61 imalo RA, 40 je imalo SLE i 56 je bilo sa SSc. Analizirani su sledeći parametri: godine života, pol, DTB, tok bolesti i indeks AB. Obavljeni su i klinički, reumatološki i neurološki pregledi, neurološki testovi, ispitivanje sprovodljivosti nervnih vlakana (SNV) i laboratorijske analize. Rezultati. U ispitivanoj populaciji, ispitivanjem SNV registrovani su različiti oblici N (kod 28,7% bolesnika). U sve tri grupe, najčešći tipovi N bile su aksonska (23,6%), senzomotorna (18,5%) i polineuropatija (23,6%). Utvrđena je statistički značajna povezanost AB i pojave N (p < 0,001) u ukupnoj populaciji. Najznačajniji EF parametri bili su amplitude senzitivnih neurograma nervus peroneus superficialis-a [kod 70 (44,6%) bolesnika] i nervus suralis-a [kod 35 (22,3%) bolesnika] i motorna amplituda nervus peroneus-a [kod 32 (20,4%) bolesnika]. DTB u sve tri grupe bila je veća u grupi bolesnika sa N. Zaključak. Kod bolesnika sa većom DTB i većom AB, N su najčešće. Elektrofiziološka metoda važna je u detekciji N, naročito u ranom otkrivanju subkliničkih formi N i prevenciji komplikacija bolesti.
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