Sertpoyraz Filiz Meryem, Tanıgör Göksel, Baydan Figen, Kale Murat Yıldırım
Department of Physical Medicine and Rehabilitation, İzmir Bakırçay University Faculty of Medicine, İzmir, Türkiye.
Department of Physical Medicine and Rehabilitation, İzmir University of Economics Faculty of Medicine, İzmir, Türkiye.
Turk J Phys Med Rehabil. 2024 Nov 14;71(2):199-205. doi: 10.5606/tftrd.2024.15025. eCollection 2025 Jun.
This study aimed to demonstrate whether a diagnosis given at the asymptomatic stage of patients with DMD can affect the clinical outcomes and to define the clinical characteristics of the patients.
The cross-sectional study was conducted with 136 male patients (mean age: 8.8±3.7 years; range, 3 to 17 years) with DMD between March 2022 and February 2023. The patients were diagnosed through clinical presentation, pathology studies, and genetic testing. The demographic, clinical, and the laboratory data of the patients were recorded. The patients were evaluated in two groups: those diagnosed at the asymptomatic stage due to elevated creatine kinase (CK) and those diagnosed due to clinical symptoms. Patients were further stratified according to their age groups: those younger than 10 years and those aged 10 years or older. Hand grip, quadriceps muscle strength, and Vignos and Brooke motor functional assessment scales of the two groups were compared.
In patients who were diagnosed with CK levels, CK elevation was significantly more common than other findings. When the age at diagnosis was evaluated, the age at diagnosis in those diagnosed with CK levels was statistically significantly lower than in those diagnosed with clinical findings. No significant difference was detected in clinical findings between the groups under the age of 10 years. Among patients aged 10 years or older, hand muscle strength, quadriceps muscle strength, and Vignos and Brooke motor function scale scores were significantly better in those diagnosed with CK levels compared to those diagnosed with clinical findings.
This study shows that early diagnosis in the preclinical period, which enables earlier medical treatment and rehabilitation, may have a positive effect on motor functions and the course of the disease.
本研究旨在证明杜氏肌营养不良症(DMD)患者无症状阶段的诊断是否会影响临床结局,并明确患者的临床特征。
2022年3月至2023年2月期间,对136例男性DMD患者(平均年龄:8.8±3.7岁;范围3至17岁)进行了横断面研究。通过临床表现、病理研究和基因检测对患者进行诊断。记录患者的人口统计学、临床和实验室数据。将患者分为两组进行评估:因肌酸激酶(CK)升高在无症状阶段被诊断的患者和因临床症状被诊断的患者。患者进一步按年龄组分层:年龄小于10岁的患者和年龄10岁及以上的患者。比较两组患者的握力、股四头肌力量以及Vignos和Brooke运动功能评估量表。
在因CK水平被诊断的患者中,CK升高比其他发现更为常见。在评估诊断年龄时,因CK水平被诊断的患者的诊断年龄在统计学上显著低于因临床表现被诊断的患者。10岁以下组之间的临床表现未检测到显著差异。在10岁及以上的患者中,与因临床表现被诊断的患者相比,因CK水平被诊断的患者的手部肌肉力量、股四头肌力量以及Vignos和Brooke运动功能量表评分明显更好。
本研究表明,临床前期的早期诊断能够实现更早的医学治疗和康复,可能对运动功能和疾病进程产生积极影响。