Neurofiziološka procena kratkoročnog ishoda farmakološkog lečenja dijabetesne neuropatije

  • Milan Cvijanović Center of Vojvodina, *Neurology Clinic, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Svetlana Simić Center of Vojvodina, *Neurology Clinic, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Aleksandar Kopitović Center of Vojvodina, *Neurology Clinic, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Ranko Raičević Military Medical Academy, Neurology Clinic, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP151209261C
Ključne reči: diabetic neuropathies||, ||dijabetesne neuropatije, electromyography||, ||elektromiografija, drug therapy||, ||lečenje lekovima, thioctic acid||, ||tioktinska kiselina, thiamine monophosphate||, ||tiamin monofosfat, gabapentin||, ||gabapentin, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod/Cilj. Dijabetesna polineuropatija (DPN) je veoma česta, progredijentna bolest koja dovodi do grubog urušavanja kvaliteta života praćenog visokom stopom invalidnosti. Iz tih razloga ispitivanje terapijskih sredstava za ovu bolest je u zamahu. Metode. Ispitivani su najčešće korišćeni lekovi za dijabetesnu neuropatiju u našem podneblju, uz elektrofiziološko praćenje da bi se izbegla subjektivnost i „placebo efekat“. Kod ukupno 120 bolesnika podeljenih u četiri grupe ispitivana je alfa lipoinska kiselina, benfotiamin i gabapentin, s tim što je elektrofiziološki praćena i grupa bolesnika koji u posmatranom periodu nisu dobijali terapiju. Analizirali smo motornu brzinu provođenja, distalnu latencu, senzitivnu brzinu provođenja, F talas i hronodisperziju F talasa, pre i posle terapije za svako pojedinačno terapijsko sredstvo. Rezultati. Evidentno je da su neki lekovi imali povoljan uticaj na stanje perifernog nerva. Alfa lipoinska kiselina i benfotiamini su imali uticaja na oporavak nerva odnosno patofiziološke procese, gabapentin je bio bez uticaja na oporavak, a slično je bilo i kod kontrolne grupe koja je bila bez bilo kakve terapije. Elektrofiziološki pokazatelji su imali različitu osetljivost na detekciju stanja perifernog neurona. Najbolji efekat koji se ogleda u povećanju senzitivne brzine provođenja imali su bolesnici koji su tretirani alfalipoičnom kiselinom. Zaključak. Uticaj alfa lipoinske kiselina i benfotiamina na stanje perifernog nerva je evidentno. Odsustvo oporavka, odnosno pogoršanje elektrofizioloških pokazatelja kod ispitanika koji nisu dobijali neuroprotektivnu terapiju, ukazuje na potrebu permanentne medikacije i periodičnog elektrofiziološkog praćenja bolesnika sa dijabetesnom polineuropatijom.

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Originalni članak