Bokuda Kota, Shimizu Toshio, Imamura Kazuhiro, Kawata Akihiro, Watabe Kazuhiko, Hayashi Masaharu, Nakayama Yuki, Isozaki Eiji, Nakano Imaharu
Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042.
Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Muscle Nerve. 2016 Aug;54(2):277-83. doi: 10.1002/mus.25051.
This study aimed to determine the prognostic factors and the values that predict survival after percutaneous endoscopic gastrostomy (PEG) tube placement in patients with amyotrophic lateral sclerosis (ALS).
We retrospectively analyzed the correlations for 97 consecutive patients with ALS between clinical parameters and survival following PEG tube placement using the log-rank test and Cox proportional-hazards models.
The log-rank test showed that an arterial carbon dioxide pressure (PaCO2 ) of ≤ 40 mmHg (P = 0.0054), a forced vital capacity (FVC) of ≥ 38% of predicted (P = 0.0003), and bulbar-onset (P = 0.0121) were significantly associated with better post-PEG survival. Multivariate analysis showed that the FVC and PaCO2 were associated with better post-PEG survival (P = 0.0081 and P = 0.0265, respectively).
PEG tube placement in ALS is recommended when FVC is ≥ 38% of predicted and when PaCO2 is normal. Muscle Nerve 54: 277-283, 2016.
本研究旨在确定肌萎缩侧索硬化症（ALS）患者经皮内镜下胃造口术（PEG）置管后的预后因素及预测生存的指标。
我们采用对数秩检验和Cox比例风险模型，回顾性分析了97例连续的ALS患者PEG置管后的临床参数与生存情况之间的相关性。
对数秩检验显示，动脉血二氧化碳分压（PaCO2）≤40 mmHg（P = 0.0054）、用力肺活量（FVC）≥预测值的38%（P = 0.0003）以及延髓起病（P = 0.0121）与PEG置管后较好的生存显著相关。多因素分析显示，FVC和PaCO2与PEG置管后较好的生存相关（分别为P = 0.0081和P = 0.0265）。
当FVC≥预测值的38%且PaCO2正常时，建议对ALS患者进行PEG置管。《肌肉与神经》54: 277 - 283, 2016年。
