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[神经肌肉疾病中功能残疾、年龄与血清酶之间的相关性]

[Correlation between functional disability, age, and serum enzymes in neuromuscular diseases].

作者信息

Werneck L C

机构信息

Departamento de Clínica Médica, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brasil.

出版信息

Arq Neuropsiquiatr. 1995 Mar;53(1):60-8. doi: 10.1590/s0004-282x1995000100010.

Abstract

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.

摘要

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。

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