Salvioni Cristina Cleide Dos Santos, Stanich Patricia, Oliveira Acary Souza Bulle, Orsini Marco
Department of Neurology and Neurosurgical, Research on Neuromuscular Disease, Federal University of Sao Paulo.
Centro Universitário Augusto Motta, Bonsucesso, Rio de Janeiro; Centro Universitario Severino Sombra, Facuty of Medicine, Vassouras, Brazil.
Neurol Int. 2015 Dec 29;7(3):5952. doi: 10.4081/ni.2015.5952.
The aim of the paper is to examine the correlation between clinical data, nutritional, respiratory and functional parameters in amyotrophic lateral sclerosis (ALS). This is a descriptive study of 111 ALS patients [91 spinal onset (GS) and 20 bulbar onset (GB)] carried on using nutritional and respiratory parameters and amyotrophic lateral sclerosis functional rating scale (ALSFRS). ALSFRS was analyzed in the main domains (D1, D2 and D3). Forced vital capacity and anthropometric measurements, there was significant association for GS and GB, and in GS there was positive correlation with midarm circumference (MAC) (r=0.30; P=0.020), midarm muscle circumference (r=0.29; P=0.026), arm muscle area (r=0.28; P=0.033) and protein-caloric malnutrition score (r=0.27; P=0.039), while for GB only with body weight (r=0.64; P=0.024). On correlation of nutritional parameters and ALSFRS for GS patients we observed that MAC and %MAC presented positive association with both issues of D1 and D2. For GB, the total score in addition to correlate positively with anthropometric parameters related to lean body mass also presented negative association with a parameter associated with body fat. In summary, it is suggested that the application of anthropometry of arm could be useful in routine monitoring of ALS patients.
本文旨在研究肌萎缩侧索硬化症（ALS）患者的临床数据、营养、呼吸和功能参数之间的相关性。这是一项对111例ALS患者（91例脊髓起病型和20例延髓起病型）进行的描述性研究，采用了营养和呼吸参数以及肌萎缩侧索硬化症功能评定量表（ALSFRS）。对ALSFRS的主要领域（D1、D2和D3）进行了分析。对于用力肺活量和人体测量指标，脊髓起病型和延髓起病型之间存在显著关联，在脊髓起病型中，与上臂围（MAC）（r = 0.30；P = 0.020）、上臂肌肉围（r = 0.29；P = 0.026）、上臂肌肉面积（r = 0.28；P = 0.033）和蛋白质-热量营养不良评分（r = 0.27；P = 0.039）呈正相关，而对于延髓起病型，仅与体重呈正相关（r = 0.64；P = 0.024）。对于脊髓起病型患者营养参数与ALSFRS的相关性，我们观察到MAC和%MAC与D1和D2的两个问题均呈正相关。对于延髓起病型，总分除了与瘦体重相关的人体测量参数呈正相关外，还与一个与体脂相关的参数呈负相关。总之，建议上臂人体测量法的应用可能有助于ALS患者的常规监测。
