Campistol Jaume, González María Julieta, Gutiérrez Alfonso Pablo, Vilaseca María Antònia
Servicio de Neurología, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.
Med Clin (Barc). 2012 Mar 3;138(5):185-91. doi: 10.1016/j.medcli.2011.03.037. Epub 2011 Jul 26.
To evaluate the management of phenylketonuria (PKU) in Spanish metabolic units and to develop a patients registry.
PKU patients diagnosed and/or followed up in Spain, with phenylalanine values before treatment > 360 μmol/L. Registered anonymous data are those yielded by the units during 2010.
Data from the 18 Spanish Follow-up Units were collected. Eighty-three per cent of Units are multidisciplinary, all of them corresponding to control patients of all ages, with uniform management criteria. Data of 688 PKU patients were registered (median: 14 years [1 month-53 years], 41.5% are presently > 18-year-old. 71.8% patients came from neonatal screening; 15.8% have mild-PKU, 26% moderate-PKU and 51.5% classic-PKU. 78.6% patients are treated with protein-restricted diet, 9.3% with BH4 and free diet and 7.8% with BH4 and diet. Dietary control was good in 58.6% patients, intermediate in 26% and poor in 15.3%. Median (range) intellectual quotients was 97 (25-145). The number of neurological complications in late diagnosed patients was three-times higher than those of neonatal screening patients. 13.3% of adults had university studies and 37.5% had a stable couple.
This study allows for the first time the evaluation of the PKU management by Spanish PKU Follow-up Units, as well as the analysis and registry of controlled PKU patients. The study makes evident the need of adult Follow-up Units and the importance of neonatal screening for PKU patients prognosis.
评估西班牙代谢病治疗单位对苯丙酮尿症(PKU)的管理情况,并建立患者登记册。
在西班牙被诊断和/或接受随访的PKU患者,治疗前苯丙氨酸值>360μmol/L。登记的匿名数据来自各单位2010年期间的记录。
收集了18个西班牙随访单位的数据。83%的单位是多学科的,所有单位均负责各年龄段的对照患者,管理标准统一。登记了688例PKU患者的数据(中位数:14岁[1个月 - 53岁],41.5%目前年龄>18岁。71.8%的患者来自新生儿筛查;15.8%为轻度PKU,26%为中度PKU,51.5%为经典型PKU。78.6%的患者采用蛋白质限制饮食治疗,9.3%采用四氢生物蝶呤(BH4)和自由饮食治疗,7.8%采用BH4和饮食治疗。58.6%的患者饮食控制良好,26%为中等,15.3%较差。智力商数中位数(范围)为97(25 - 145)。晚诊断患者的神经并发症数量比新生儿筛查患者高三倍。13.3%的成年人接受过大学教育,37.5%有稳定伴侣。
本研究首次对西班牙PKU随访单位的PKU管理情况进行了评估,同时对PKU对照患者进行了分析和登记。该研究明确了成人随访单位的必要性以及新生儿筛查对PKU患者预后的重要性。