Johnson Nicholas E, Ekstrom Anne-Berit, Campbell Craig, Hung Man, Adams Heather R, Chen Wei, Luebbe Elizabeth, Hilbert James, Moxley Richard T, Heatwole Chad R
Department of Neurology, The University of Utah, Salt Lake City, UT, USA.
Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Dev Med Child Neurol. 2016 Jul;58(7):698-705. doi: 10.1111/dmcn.12948. Epub 2015 Oct 28.
The frequency and impact of symptoms experienced by patients with congenital, childhood, and juvenile-onset myotonic dystrophy (CDM/ChDM/JDM) is not documented. This report identifies symptomatic areas with the greatest disease burden in an international population of patients with early-onset myotonic dystrophy type-1 (DM1).
We distributed surveys to parents of patients with CDM/ChDM/JDM. Patients with CDM/ChDM/JDM were members of the US National Registry of DM1 Patients and Family Members, the Canadian Neuromuscular Disease Registry, or the Swedish Health System. Surveys inquired about 325 symptoms and 20 themes associated with CDM/ChDM/JDM. Parents identified the importance of each symptom and theme to their affected child. The prevalence of each symptom and theme were compared across subgroups of patients. The statistical analysis was performed using Fisher's exact and Kruskal-Wallis tests.
One hundred and fifty parents returned surveys. The most frequently reported symptomatic themes in children were issues involving communication (81.7%) and problems with hands or fingers (79.6%). Problems with communication and fatigue were the issues that were reported to have the greatest impact on childrens' lives, while 24.1% of children reported cardiac disorders and 15.8% had problems with anesthesia.
A range of symptoms contribute to the burden of disease faced by children with DM1. Many of these symptoms are under-recognized.
先天性、儿童期及青少年期发病的强直性肌营养不良(CDM/ChDM/JDM)患者所经历症状的频率和影响尚无文献记载。本报告确定了早发型1型强直性肌营养不良(DM1)国际患者群体中疾病负担最大的症状领域。
我们向CDM/ChDM/JDM患者的父母发放了调查问卷。CDM/ChDM/JDM患者是美国DM1患者及家庭成员国家登记处、加拿大神经肌肉疾病登记处或瑞典卫生系统的成员。调查问卷询问了与CDM/ChDM/JDM相关的325种症状和20个主题。父母们确定了每种症状和主题对其患病子女的重要性。比较了各亚组患者中每种症状和主题的患病率。采用Fisher精确检验和Kruskal-Wallis检验进行统计分析。
150名父母返回了调查问卷。儿童中最常报告的症状主题是涉及沟通的问题(81.7%)和手部或手指问题(79.6%)。沟通问题和疲劳是据报告对儿童生活影响最大的问题,而24.1%的儿童报告有心脏疾病,15.8%的儿童有麻醉问题。
一系列症状导致了DM1儿童所面临的疾病负担。其中许多症状未得到充分认识。