Ivanova Kristīne, Žukovs Daniils, Možeitoviča Evelīna, Rots Dmitrijs, Kurjāne Nataļja, Ķēniņa Viktorija
Riga Stradins, Riga, Latvia.
Pauls Stradins Clinical University Hospital, Riga, Latvia.
Neurol Neurochir Pol. 2023;57(2):206-211. doi: 10.5603/PJNNS.a2023.0018. Epub 2023 Mar 14.
Systemic sclerosis (SSc) is a chronic rheumatic disease that affects multiple organ systems, including the peripheral nervous system. However, studies into the involvement of polyneuropathies (PNP) have shown inconsistent results. The aim of this study was to determine the prevalence of small (SFN) and large (LFN) fibre neuropathy among SSc patients and the impact on health-related quality of life (HRQoL).
The study enrolled 67 patients with diagnosed SSc. The severity of neuropathic symptoms was evaluated using shortened and revised total neuropathy scoring criteria. Nerve conduction studies were used for LFN, and quantitative sensory testing was used to evaluate SFN. Neuropathic pain was evaluated using a Douleur Neuropathique en 4 questionnaire, and the severity of anxiety symptoms was assessed using a Generalised Anxiety Disorder-7 scale. The Health Assessment Questionnaire-Disability Index was used to assess HRQoL. Previous data on antinuclear autoantibodies (ANA) test results was obtained. Statistical analysis was performed using SPSS software.
LFN was diagnosed in 47.8% (n = 32/67) and SFN in 40.3% (n = 27/67) of the subjects. ANA positivity was not associated with the presence of LFN/SFN. The severity of neuropathic pain had a significant correlation with anxiety symptoms (r = 0.61, p < 0.001), the severity of neuropathy symptoms (r = 0.51, p < 0.001) and HRQoL (r = 0.45, p < 0.001). The severity of neuropathy symptoms correlated with HRQoL (r = 0.39, p = 0.001).
We demonstrated that PNP are found in almost all SSc patients. Also, SFN is as common as LFN. Additionally, we found that the severity of neuropathy symptoms and neuropathic pain are both associated with a worse HRQoL.
系统性硬化症(SSc)是一种慢性风湿性疾病,可累及多个器官系统,包括周围神经系统。然而,关于多发性神经病(PNP)受累情况的研究结果并不一致。本研究的目的是确定系统性硬化症患者中小(SFN)和大(LFN)纤维神经病变的患病率及其对健康相关生活质量(HRQoL)的影响。
本研究纳入了67例确诊为系统性硬化症的患者。使用简化和修订的总神经病变评分标准评估神经病变症状的严重程度。神经传导研究用于评估LFN,定量感觉测试用于评估SFN。使用4分量表的神经病理性疼痛问卷评估神经病理性疼痛,并使用广泛性焦虑障碍-7量表评估焦虑症状的严重程度。健康评估问卷-残疾指数用于评估HRQoL。获取先前关于抗核自身抗体(ANA)检测结果的数据。使用SPSS软件进行统计分析。
47.8%(n = 32/67)的受试者被诊断为LFN,40.3%(n = 27/67)的受试者被诊断为SFN。ANA阳性与LFN/SFN的存在无关。神经病理性疼痛的严重程度与焦虑症状(r = 0.61,p < 0.001)、神经病变症状的严重程度(r = 0.51,p < 0.001)和HRQoL(r = 0.45,p < 0.001)显著相关。神经病变症状的严重程度与HRQoL相关(r = 0.39,p = 0.001)。
我们证明几乎所有系统性硬化症患者都存在PNP。此外,SFN与LFN一样常见。此外,我们发现神经病变症状和神经病理性疼痛的严重程度均与较差的HRQoL相关。