Sekundāri progresējošas multiplas sklerozes diagnostikas aizkavēšanās Rīgas Austrumu klīniskās universitātes slimnīcas multiplās sklerozes pacientiem
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Multiplā skleroze (MS) ir visbiežākā iekaisīgi-demielinizējoša CNS slimība gados jauniem pacientiem. Patoģenēze ir saistīta ar autoimunitāti un demielinizāciju ģenētiski predisponētiem indivīdiem.
MS tiek diagnosticēta klīniski un radioloģiski, balstoties uz demielinizēto perēkļu izplatību laikā un telpā, izmantojot McDonald kritērijus. Simptomi variē atkarībā no perēkļu lokalizācijas un plašuma.
Pēc klīniskās norises MS tiek iedalīta 4 veidos: klīniski izolēts sindroms, recidivējoši - remitējoša MS, sekundāri progresējoša MS, primāri progresējoša MS. Slimības novērtēšanai tiek izmantota funkcionālās nespējas skala jeb EDSS (Expanded Disability Status Scale), kura ir balstīta uz neiroloģisko traucējumu vērtējumu un pacienta spēju staigāt. EDSS tiek pielietota arī klīniskas MS diagnozes uzstādīšanai. Diemžēl, joprojām nav stingru kritēriju sekundāri progresējošas MS diagnozes uzlikšanai, bet tā bieži tiek piešķirta pacientiem ar iepriekšēji recidivējoši - remitējošu MS gaitu un EDSS > 4. MS nav pilnīgi izārstējama un atstāj paliekošo neiroloģisko defektu, būtiski ietekmējot pacientu dzīves kvalitāti.
Pētījumā tiek apkopoti MS pacientu dati no 2014. - 2019. g. Rīgas Austrumu klīniskā universitātes slimnīcā. Tiek atspoguļots MS pacientu īpatsvars ar izteiktu funkcionālo nespēju, ko raksturo novērtējums pēc EDSS skalas virs 4 ballēm, katrā klīniskās norises grupā un terapijas grupā. Noskaidrots recidivējoši – remitējošu MS pacientu skaits ar izteiktu funkcionālo nespēju un potenciālu risku pāriet sekundāri progresējošā MS klīniskajā formā.
Multiple sclerosis (MS) is the most common demyelinating disease with autoimmune substance in genetically susceptible individuals with higher incidence between young people. The diagnosis of MS is based on clinical and radiological findings applying McDonald criteria. MS is resulting in one or more episodes of neurologic dysfunction with a variable course of recovery as well as disease progression. Symptoms vary depending on lesion localization and size. There are following disease phenotypes: relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinically isolated syndrome (CIS). For estimation patients’ disability Expanded Disability Status Scale (EDSS) is used. Unfotunatelly there is no available test to confirm SPMS, minimal EDSS = 4 is needed to establish diagnosis for patients with previous RRMS. The diagnostic criteria of SPMS is still challenging and diagnosis is often made retrospectively. MS is incurable, leaves significant neurological deffects and reduces quality of life. In this research the total number of MS patients at Riga East University Hospital between 2014 – 2019 year were calculated. The functional disability of patients applying the EDSS scale in each MS phenotype and MS treatment group was evaluated. The number of RRMS patients with possible SPMS course applying EDSS criteria was found.
Multiple sclerosis (MS) is the most common demyelinating disease with autoimmune substance in genetically susceptible individuals with higher incidence between young people. The diagnosis of MS is based on clinical and radiological findings applying McDonald criteria. MS is resulting in one or more episodes of neurologic dysfunction with a variable course of recovery as well as disease progression. Symptoms vary depending on lesion localization and size. There are following disease phenotypes: relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinically isolated syndrome (CIS). For estimation patients’ disability Expanded Disability Status Scale (EDSS) is used. Unfotunatelly there is no available test to confirm SPMS, minimal EDSS = 4 is needed to establish diagnosis for patients with previous RRMS. The diagnostic criteria of SPMS is still challenging and diagnosis is often made retrospectively. MS is incurable, leaves significant neurological deffects and reduces quality of life. In this research the total number of MS patients at Riga East University Hospital between 2014 – 2019 year were calculated. The functional disability of patients applying the EDSS scale in each MS phenotype and MS treatment group was evaluated. The number of RRMS patients with possible SPMS course applying EDSS criteria was found.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Demielinizējoša slimība, multiplā skleroze, funkcionālās nespējas skala., Demyelinating disease, multiple sclerosis, Expanded Disability Status Scale.