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杜氏肌营养不良症不同阶段症状的发生及其对社会参与的影响。

Occurrence of symptoms in different stages of Duchenne muscular dystrophy and their impact on social participation.

机构信息

Amalia Children's Hospital, Nijmegen, The Netherlands.

Radboud University, Nijmegen, The Netherlands.

出版信息

Muscle Nerve. 2021 Dec;64(6):701-709. doi: 10.1002/mus.27406. Epub 2021 Sep 9.

Abstract

INTRODUCTION/AIMS: As life expectancy improves for patients with Duchenne muscular dystrophy (DMD), new symptoms are likely to arise. This aims of this study are: (1) to explore the prevalence of a broad variety of symptoms in the various stages of DMD (with and without steroid use); (2) to explore the prevalence of common secondary diagnoses; and (3) to evaluate the social participation level of patients with DMD older than 16 y of age; and to explore correlations between social participation and symptoms.

METHODS

A cross-sectional self-report questionnaire, including questions on functional level and health status, as well as a standardized participation scale was distributed among Dutch patients with DMD.

RESULTS

Eighty-four male patients with a mean age of 22.0 (SD = 10.0) y were enrolled. The most prevalent and limiting symptoms were difficulty coughing (58%), coldness of hands (57%), contractures (51%), stiffness (49%), fatigue (40%), myalgia (38%), and low speech volume (33%). Prevalent secondary diagnoses included cardiac disease (14%), neurobehavioral diagnosis (13%), low blood pressure (13%), and arthrosis (5%). Social participation correlated negatively with coldness of hands (r = - .29; P < .03), decreased intelligibility (r = - .40; P < .003), and chewing problems (r = - .33; P < .02).

DISCUSSION

The prevalence of a broad spectrum of symptoms and secondary diagnoses is high in patients with DMD, and some of these symptoms are correlated with social participation. Growing awareness of new symptoms and secondary diagnoses among patients, caregivers, and professionals can enhance their recognition, possibly facilitating prevention and early treatment.

摘要

引言/目的:随着杜兴氏肌营养不良症(DMD)患者的预期寿命延长,新的症状可能会出现。本研究的目的是:(1)探讨 DMD 各个阶段(使用和不使用类固醇)各种症状的患病率;(2)探讨常见次要诊断的患病率;(3)评估年龄超过 16 岁的 DMD 患者的社会参与水平;并探讨社会参与与症状之间的相关性。

方法

一项横断面的自我报告问卷,包括功能水平和健康状况的问题,以及一个标准化的参与量表,分发给荷兰的 DMD 患者。

结果

共纳入 84 名男性患者,平均年龄为 22.0(SD=10.0)岁。最常见和最受限的症状是咳嗽困难(58%)、手冷(57%)、挛缩(51%)、僵硬(49%)、疲劳(40%)、肌痛(38%)和言语音量低(33%)。常见的次要诊断包括心脏病(14%)、神经行为诊断(13%)、低血压(13%)和关节炎(5%)。社会参与与手冷(r=-0.29;P<0.03)、可懂度降低(r=-0.40;P<0.003)和咀嚼问题(r=-0.33;P<0.02)呈负相关。

讨论

DMD 患者存在广泛的症状和次要诊断,其中一些症状与社会参与有关。提高患者、护理人员和专业人员对新症状和次要诊断的认识,可以增强他们的认识,可能有助于预防和早期治疗。

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