Werneck L C
Departamento de Clínica Médica, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brasil.
Arq Neuropsiquiatr. 1995 Mar;53(1):60-8. doi: 10.1590/s0004-282x1995000100010.
We attempt to correlate the patient's disability and serum enzymes (creatinekinase, lactic dehydrogenase, aldolase, glutamic oxalacetic and glutamic piruvic transaminase) in several neuromuscular disorders using the Vignos and Archibald scale (V&A). In 806 cases we studied, serum enzyme levels and the V&A disability using a computer for Pearson's correlation and regressive analysis. A good correlation of the V&A with age suggested a progressive evolution (increased disability) in Duchenne muscular dystrophy, fascioscapulohumeral dystrophy, myotonic dystrophy, myopathies due to respiratory chain enzyme deficiency and amyotrophic lateral sclerosis. A negative correlation (decrease disability with age) was found for multicore myopathy, benign myopathy of childhood with type 1 predominance, carnitine myopathy deficiency and dermatomyositis. It was found a correlation (p < 0.05) of the V&A and the level of specific serum enzymes with Duchenne muscular dystrophy, oculocraniosomatic dystrophies, polymyositis and polyarteritis nodosa. Using regression analysis, we found a weak interrelation between serum enzymes studied simultaneously and the V&A. These weak relations suggest some limitation in the long term use of the five serum enzymes in the evaluation of neuromuscular disorders when compared with V&A; although they are very important in the diagnosis.
我们试图使用维格诺斯和阿奇博尔德量表(V&A),将几种神经肌肉疾病患者的残疾情况与血清酶(肌酸激酶、乳酸脱氢酶、醛缩酶、谷草转氨酶和谷丙转氨酶)进行关联。在我们研究的806例病例中,使用计算机对血清酶水平和V&A残疾情况进行了Pearson相关性和回归分析。V&A与年龄的良好相关性表明,在杜氏肌营养不良症、面肩肱型肌营养不良症、强直性肌营养不良症、呼吸链酶缺乏所致肌病和肌萎缩侧索硬化症中存在病情进展(残疾程度增加)。在多核肌病、以1型为主的儿童良性肌病、肉碱肌病缺乏症和皮肌炎中发现呈负相关(残疾程度随年龄降低)。发现V&A与特定血清酶水平与杜氏肌营养不良症、眼颅躯体性肌营养不良症、多发性肌炎和结节性多动脉炎之间存在相关性(p < 0.05)。通过回归分析,我们发现同时研究的血清酶与V&A之间存在微弱的相互关系。这些微弱关系表明,与V&A相比,这五种血清酶在长期评估神经肌肉疾病时存在一定局限性;尽管它们在诊断中非常重要。