Beghi E, Monticelli M L
Istituto di Richerche Farmacologiche Mario Negri, Milan, Italy.
J Clin Epidemiol. 1998 Aug;51(8):697-702. doi: 10.1016/s0895-4356(98)00039-0.
A total of 4191 patients 55 years and older were screened for clinical features and risk factors of polyneuropathy by 27 general practitioners (GPs) in two areas of Italy (Varese and San Giovanni Rotondo). Polyneuropathy was diagnosed in the presence of two or more symptoms associated with bilateral impairment of at least two of the following: strength, sensation, tendon reflexes. A risk factor for polyneuropathy (associated disease or neurotoxic agent) was recorded based on its presence in the GP's records, the presence of specific treatments, or an affirmative answer to the interviewer's question. The prevalence of polyneuropathy among patients with no recognized exposure to diseases or neurotoxic agents was 1.6% (Varese 1.6%; San Giovanni Rotondo 1.8%). The corresponding values were 11.8% (Varese 11.8%; San Giovanni Rotondo 11.9%) for patients with one risk factor, and 17.3% (Varese 19.2%; San Giovanni Rotondo 13.0%) for patients with two risk factors. Combining the two populations, the prevalence of polyneuropathy was highest in diabetics (18.3%), followed by patients with a diagnosis of alcoholism (12.5%), non-alcoholic liver disease (10.9%), and tumor (7.1%). Diabetes was the commonest independent risk factor for polyneuropathy (odds ratio 11.3), followed by alcoholism (7.4), non-alcoholic liver disease (4.9), and tumor (2.6).
在意大利的两个地区(瓦雷泽和圣乔瓦尼罗通多),27名全科医生(GP)对总共4191名55岁及以上的患者进行了多神经病的临床特征和危险因素筛查。当出现两种或更多与以下至少两项双侧损害相关的症状时,诊断为多神经病:肌力、感觉、腱反射。根据全科医生记录中的存在情况、特定治疗的存在情况或对访谈者问题的肯定回答,记录多神经病的危险因素(相关疾病或神经毒性剂)。在未确认接触疾病或神经毒性剂的患者中,多神经病的患病率为1.6%(瓦雷泽1.6%;圣乔瓦尼罗通多1.8%)。有一个危险因素的患者相应数值为11.8%(瓦雷泽11.8%;圣乔瓦尼罗通多11.9%),有两个危险因素的患者为17.3%(瓦雷泽19.2%;圣乔瓦尼罗通多13.0%)。将两个人群合并后,多神经病患病率在糖尿病患者中最高(18.3%),其次是诊断为酒精中毒的患者(12.5%)、非酒精性肝病患者(10.9%)和肿瘤患者(7.1%)。糖尿病是多神经病最常见的独立危险因素(比值比11.3),其次是酒精中毒(7.4)、非酒精性肝病(4.9)和肿瘤(2.6)。