Chiò A, Cocito D, Bottacchi E, Buffa C, Leone M, Plano F, Mutani R, Calvo A
Department of Neuroscience, University of Torino, Italy.
J Neurol Neurosurg Psychiatry. 2007 Dec;78(12):1349-53. doi: 10.1136/jnnp.2007.114868. Epub 2007 May 10.
The clinical and epidemiological characteristics of chronic inflammatory demyelinating polyneuropathy (CIDP) in an Italian population were assessed.
All subjects with a diagnosis of demyelinating neuropathy after 1990 in Piemonte and Valle d'Aosta (4,334,225 inhabitants) were considered. The diagnosis of CIDP was based on the research criteria of the American Academy of Neurology. 165 of 294 patients met the diagnostic criteria.
The crude prevalence rate was 3.58/100,000 population (95% CI 3.02 to 4.20). At the prevalence day, 76 (49.0%) cases had definite, 67 (43.2%) probable and 12 (7.7%) possible CIDP; disability was mild in 105 (67.7%) cases, moderate in 32 (20.6%) and severe in 18 (11.6%). The course was remitting-relapsing in 40 cases (25.8%), chronic progressive in 96 (61.9%) and monophasic in 19 (12.3%). Considering the 95 patients whose disorder presented in the period 1995-2001, the mean annual crude incidence rate was 0.36/100,000 population (95% CI 0.29 to 0.44), with a male to female ratio of 2.3:1. 14 cases were affected by diabetes mellitus. In multivariate analysis, factors related to severe disability at the prevalence day were: age >60 years; failure of immunomodulating therapies at the time of diagnosis; worse disability at nadir; and chronic course.
Incidence and prevalence rates of CIDP in Italy were higher than those observed in most previous studies. At the prevalence day, more than 80% of cases had a mild or moderate disability, indicating either a good response to immunomodulating therapy or a tendency of CIDP to have a mild course in most cases.
评估意大利人群慢性炎症性脱髓鞘性多发性神经病(CIDP)的临床和流行病学特征。
纳入1990年后在皮埃蒙特和瓦莱达奥斯塔(4334225名居民)被诊断为脱髓鞘性神经病的所有患者。CIDP的诊断基于美国神经病学学会的研究标准。294例患者中有165例符合诊断标准。
粗患病率为3.58/10万人口(95%可信区间3.02至4.20)。在患病当日,76例(49.0%)为确诊CIDP,67例(43.2%)为可能CIDP,12例(7.7%)为疑似CIDP;105例(67.7%)患者残疾程度为轻度,32例(20.6%)为中度,18例(11.6%)为重度。病程呈缓解-复发型的有40例(25.8%),慢性进行型的有96例(61.9%),单相型的有19例(12.3%)。对于1995 - 2001年期间发病的95例患者,年平均粗发病率为0.36/10万人口(95%可信区间0.29至0.44),男女比例为2.3:1。14例患者患有糖尿病。多因素分析显示,患病当日与严重残疾相关的因素为:年龄>60岁;诊断时免疫调节治疗无效;最低点时残疾程度更严重;以及慢性病程。
意大利CIDP的发病率和患病率高于大多数以往研究中观察到的水平。在患病当日,超过80%的病例残疾程度为轻度或中度,这表明免疫调节治疗反应良好,或者在大多数情况下CIDP倾向于病程较轻。