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多发性硬化症患者共病的患病率及其与残疾进展的关联:一项来自巴西的研究。

The Prevalence of Comorbidities and Their Association With Disability Progression in Individuals With Multiple Sclerosis: A Study From Brazil.

作者信息

Gralha de Caneda Marco Aurélio, Batista Oliveira Silva Camila, Aragon de Vecino Maria Cecília

机构信息

From the Multiple Sclerosis and Demyelinating Disorders Unit, Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.

Vecino Medical Center, Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Int J MS Care. 2024 Mar 9;26(Q3):239-246. doi: 10.7224/1537-2073.2023-103. eCollection 2024 May.

Abstract

BACKGROUND

Comorbidities negatively impact the course of multiple sclerosis (MS). Identifying them is essential, as they represent potentially modifiable prognostic factors that can adversely influence the disease course. However, comorbidity prevalence remains underexplored in certain populations, including in individuals in Brazil.

METHODS

In this cross-sectional study, we describe the frequency of comorbidities and their correlation with MS disability progression in a Brazilian population by reviewing the medical records of patients from a single MS center in Brazil. Preexisting comorbidities and those present at the time of MS diagnosis were screened. We assessed the prevalence of comorbidities, their prevalence ratios (PR) and the association between them, their number, and the confirmed disability worsening (CDW) that emerged during the follow-up visits.

RESULTS

Comorbidities were present in 68.9% of individuals. The most prevalent comorbidities included cardiovascular diseases (19.3%), migraine (13.3%), psychiatric disorders (12.4%), smoking (12.4%), autoimmune diseases (12.0%), respiratory diseases (10.3%), and neoplasms (5.6%). Patients with 1 comorbidity and those with multiple comorbidities (≥ 3) had a significant PR for CDW (2.67, = .01; 1.25, = .03, respectively). Cardiovascular and autoimmune diseases presented significant PR for CDW (2.28, = .03; 4.2, = .004, respectively).

CONCLUSIONS

Comorbidities are more prevalent among Brazilian individuals with MS than in the general population and are associated with disease progression. Identifying and managing them may mitigate their adverse effects on disease course.

摘要

背景

合并症会对多发性硬化症(MS)的病程产生负面影响。识别这些合并症至关重要,因为它们代表了可能可改变的预后因素,会对疾病进程产生不利影响。然而,在某些人群中,包括巴西的个体,合并症的患病率仍未得到充分研究。

方法

在这项横断面研究中,我们通过回顾巴西单个MS中心患者的病历,描述了巴西人群中合并症的频率及其与MS残疾进展的相关性。筛查了既往存在的合并症以及MS诊断时存在的合并症。我们评估了合并症的患病率、患病率比(PR)以及它们之间的关联、合并症的数量,以及随访期间出现的确诊残疾恶化(CDW)情况。

结果

68.9%的个体存在合并症。最常见的合并症包括心血管疾病(19.3%)、偏头痛(13.3%)、精神障碍(12.4%)、吸烟(12.4%)、自身免疫性疾病(12.0%)、呼吸系统疾病(10.3%)和肿瘤(5.6%)。患有1种合并症和患有多种合并症(≥3种)的患者CDW的PR显著(分别为2.67,P = 0.01;1.25,P = 0.03)。心血管疾病和自身免疫性疾病的CDW呈现出显著的PR(分别为2.28,P = 0.03;4.2,P = 0.004)。

结论

巴西MS患者中合并症的患病率高于一般人群,且与疾病进展相关。识别并管理这些合并症可能会减轻它们对疾病进程的不利影响。

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