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肌强直性营养不良患者的吞咽相关生活质量和口咽性吞咽困难。

Swallow-related quality of life and oropharyngeal dysphagia in myotonic dystrophy.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.

School for Mental Health and Neuroscience, MHeNs, Maastricht University, Maastricht, The Netherlands.

出版信息

Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2357-2362. doi: 10.1007/s00405-020-05964-2. Epub 2020 Apr 15.

Abstract

PURPOSE

This study describes swallow-related quality of life (SWAL-QOL) in patients with myotonic dystrophy type 1 (DM1) and investigates its association with swallowing function and disease severity.

METHODS

A SWAL-QOL questionnaire was completed by 75 DM1 patients and 25 healthy control subjects. The severity of the disease was evaluated using the muscular impairment rating scale (MIRS). Twenty-eight DM1 patients underwent a videofluroscopic swallowing examination (VFS). Spearman's correlation coefficient was used to measure the direction and strength of associations.

RESULTS

The SWAL-QOL median scores were significantly lower for the DM1 group than for the healthy control group. The scores for the majority of the SWAL-QOL domains were lower in patients with proximal muscular weakness (MIRS 4 and 5). Postswallow vallecular pooling and piecemeal deglutition were the most impaired VFS outcome variables.

CONCLUSION

Our results suggest that a multidimensional swallowing assessment is recommended for DM1 patients as SWAL-QOL and VFS measure different aspects of the swallowing function, thus providing complementary information.

摘要

目的

本研究描述了肌强直性营养不良 1 型(DM1)患者的吞咽相关生活质量(SWAL-QOL),并探讨了其与吞咽功能和疾病严重程度的关系。

方法

75 例 DM1 患者和 25 名健康对照者完成了 SWAL-QOL 问卷。使用肌肉损伤评分量表(MIRS)评估疾病严重程度。28 例 DM1 患者接受了视频荧光吞咽检查(VFS)。采用 Spearman 相关系数来衡量关联的方向和强度。

结果

DM1 组的 SWAL-QOL 中位数评分明显低于健康对照组。大多数 SWAL-QOL 领域的评分在近端肌肉无力的患者中较低(MIRS 4 和 5)。吞咽后会厌谷滞留和碎块吞咽是 VFS 最受损的结果变量。

结论

我们的研究结果表明,建议对 DM1 患者进行多维吞咽评估,因为 SWAL-QOL 和 VFS 测量吞咽功能的不同方面,因此提供互补的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b0/7335374/a64e27bdd4b7/405_2020_5964_Fig1_HTML.jpg

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