Wang Yao, Yang Xiaoyu, Han Qun, Liu Min, Zhou Chang
Department of Neurology, (Y.W., X.Y., M.L.) The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
Department of Neurology, (Y.W., X.Y., M.L.) The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
J Pain Symptom Manage. 2022 Apr;63(4):e387-e396. doi: 10.1016/j.jpainsymman.2021.12.005. Epub 2021 Dec 15.
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative motor neuron disease (MND), and sialorrhea is a known symptom in patients with ALS, which may cause a social embarrassment and discomfort. However, people do not pay attention to sialorrhea up to now. This study is aimed at conducting a systematic review and meta-analysis of the pooled prevalence of sialorrhea in ALS patients all around the world and raising awareness of salivation.
We searched PubMed and EMBASE databases to obtain the comprehensive literatures which reported the prevalence of sialorrhea. We used AHRQ and NOS to evaluate the literature quality. Subgroup analyses were performed based on screening instruments and severity of sialorrhea. At the meantime, sensitivity analyses was also conducted to identify the source of heterogeneity.
A total of 17 eligible studies which included 21 groups of data reported prevalence of sialorrhea. The pooled prevalence of sialorrhea among ALS patients was 30.8% (95% CI: 20.0%-44.2%). For studies using ALSFRS-R, direct questioning, postal survey, and ALSSoL average and ALSFRS-R, the pooled prevalence of sialorrhea was 22.7%, 25.8%, 29.8% and 52.0% respectively. According to the severity of sialorrhea, the prevalence of mild, moderate, and severe sialorrhea were 25.1%, 11.2%, and 10.5%, respectively. And none of the studies alone had a significant effect on the overall prevalence of sialorrhea after we eliminated each study separately in sensitivity analyses.
Sialorrhea is a relatively common symptom in ALS patients with a comparatively high prevalence. In our study, we found that the prevalence of sialorrhea in ALS patients is relatively higher than the results based on direct questioning or postal survey. Therefore, we deduced that sialorrhea should be evaluated by more complex professional assessment scales to improve the quality of life and improve early prognosis of disease.
肌萎缩侧索硬化症（ALS）是一种致命的神经退行性运动神经元疾病（MND），流涎是ALS患者的一种已知症状，可能会导致社交尴尬和不适。然而，迄今为止人们对流涎问题并不重视。本研究旨在对全球范围内ALS患者流涎的合并患病率进行系统评价和荟萃分析，并提高对口涎分泌的认识。
我们检索了PubMed和EMBASE数据库，以获取报告流涎患病率的综合文献。我们使用AHRQ和NOS评估文献质量。基于筛查工具和流涎严重程度进行亚组分析。同时，还进行了敏感性分析以确定异质性来源。
共有17项符合条件的研究，包括21组数据报告了流涎患病率。ALS患者中流涎的合并患病率为30.8%（95%CI：20.0%-44.2%）。对于使用ALSFRS-R、直接询问、邮政调查以及ALSSoL平均值和ALSFRS-R的研究，流涎的合并患病率分别为22.7%、25.8%、29.8%和52.0%。根据流涎的严重程度，轻度、中度和重度流涎的患病率分别为25.1%、11.2%和10.5%。在敏感性分析中逐一剔除每项研究后，没有一项研究单独对流涎的总体患病率有显著影响。
流涎是ALS患者中相对常见的症状，患病率较高。在我们的研究中，我们发现ALS患者中流涎的患病率相对高于基于直接询问或邮政调查的结果。因此，我们推断应通过更复杂的专业评估量表对流涎进行评估，以提高生活质量并改善疾病的早期预后。
