Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Neurol India. 2019 May-Jun;67(3):732-737. doi: 10.4103/0028-3886.263171.
Restless leg syndrome (RLS) has been reported to be common in patients with cirrhosis. The relation of RLS with severity of liver disease is, however, unclear.
We studied the association between occurrence of RLS and severity of cirrhosis.
Single centre, prospective, observational study.
Adult patients with cirrhosis and relatively stable clinical condition and no associated neurological condition were prospectively studied. Severity of liver disease was graded as Child-Turcotte-Pugh (CTP) class A, B or C; using Model for End-Stage Liver Disease (MELD) score; and as a binary variable (compensated or decompensated disease). Each subject underwent an initial screening for RLS, followed by a re-evaluation by an independent neurologist to confirm the diagnosis, using the International RLS Diagnostic Criteria. In patients with RLS, its severity was assessed using a validated Hindi translation of the International RLS severity (IRLS) scoring system.
Data for categorical variables were expressed as proportions and compared using chi-squared test, and those for numerical variables were expressed as median and range, and compared using Wilcoxon rank sum test.
Among the 356 patients with cirrhosis studied (median [range] age: 48 [18-83] years; 241 [67.7%] male; CTP A/163, B/172, C/21; MELD 11 [6-41]; decompensated 51.7%), 36 (10.1%) had RLS. RLS severity was mild (1), moderate (15), severe (19) or very severe (1). Compared to those without RLS, patient with RLS had a lower MELD score (9 [6-25] versus 11 [6-41], P = 0.04), and a comparable distribution of CTP classes and frequency of decompensated liver disease. The prevalence and severity of RLS were not different between those with compensated and those with decompensated cirrhosis.
In the Indian population, RLS is common in patients with cirrhosis. Its occurrence did not show any increase with the severity of liver disease.
不宁腿综合征（RLS）在肝硬化患者中较为常见。然而，RLS 与肝脏疾病严重程度的关系尚不清楚。
我们研究了 RLS 的发生与肝硬化严重程度之间的关系。
单中心、前瞻性、观察性研究。
前瞻性研究患有肝硬化且临床状况相对稳定且无相关神经系统疾病的成年患者。采用 Child-Turcotte-Pugh（CTP）分级（A、B 或 C）、终末期肝病模型（MELD）评分和（代偿或失代偿疾病）二分类变量来评估肝脏疾病的严重程度。每位患者首先进行 RLS 的初步筛查，然后由独立的神经科医生根据国际 RLS 诊断标准进行重新评估以确认诊断。对于 RLS 患者，使用经过验证的印地语翻译的国际 RLS 严重程度（IRLS）评分系统评估其严重程度。
分类变量的数据表示为比例，并使用卡方检验进行比较；数值变量的数据表示为中位数和范围，并使用 Wilcoxon 秩和检验进行比较。
在研究的 356 例肝硬化患者中（中位[范围]年龄：48[18-83]岁；241[67.7%]为男性；CTP A/163、B/172、C/21；MELD 11[6-41]；51.7%为失代偿），36 例（10.1%）患有 RLS。RLS 的严重程度为轻度（1）、中度（15）、重度（19）或极重度（1）。与无 RLS 的患者相比，RLS 患者的 MELD 评分较低（9[6-25]与 11[6-41]，P=0.04），且 CTP 分级和失代偿性肝病的发生率相似。代偿性和失代偿性肝硬化患者的 RLS 患病率和严重程度无差异。
在印度人群中，RLS 在肝硬化患者中较为常见。其发生与肝脏疾病的严重程度无关。
