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[苯丙酮尿症患者的治疗与控制:西班牙随访单位协作组的结果]

[Treatment and control of patients with phenylketonuria: results from the Collaborative Group of Spanish Follow-up Units].

作者信息

Campistol Jaume, González María Julieta, Gutiérrez Alfonso Pablo, Vilaseca María Antònia

机构信息

Servicio de Neurología, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.

出版信息

Med Clin (Barc). 2012 Mar 3;138(5):185-91. doi: 10.1016/j.medcli.2011.03.037. Epub 2011 Jul 26.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate the management of phenylketonuria (PKU) in Spanish metabolic units and to develop a patients registry.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景与目的

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。

患者与方法

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。

结果

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。

结论

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。

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