| Sažetak | Ciljevi: Glavni cilj ovog istraživanja bilo je prikazati promjene u rutinskim laboratorijskim
pretragama iz krvi te ispitati povezanost tih promjena s demografskim varijablama i kliničkom
prezentacijom oboljelih od ALS-a.
Ispitanici i postupci: Istraživanje je provedeno u Klinici za neurologiju KBC Split u obliku
retrospektivnog kohortnog istraživanja. U ispitivanje je bilo uključeno 26 pacijenata oboljelih
od ALS-a s nalazima laboratorijskih parametara iz krvi koji su rutinski izvađeni u svrhu obrade
pacijenta. Podatci su prikupljeni iz arhive Klinike za neurologiju KBC Split iz razdoblja
2017.-2021. Prikupljeni nalazi uključivali su podatke o spolu, dobi, dobi pri postavljanju
dijagnoze, inicijalno zahvaćenu regiju tijela, kliničkoj prezentaciji te podatke
o laboratorijskim nalazima iz krvi. Dobiveni rezultati prikazani su uz pomoć apsolutnih
i relativnih brojki, a statistička je povezanost interpretirana na razini značajnosti od P<0,05
i P<0,01.
Rezultati: U ovom istraživanju sudjelovalo je 15 (57%) muškaraca i 11 (43%) žena. Raspon
dobi pacijenata bila je od 37 do 91 godine. Prosječna dob sudionika bila je 68,58 dok je
prosječna dob u kojoj je postavljena dijagnoza bila 64,12. Najčešći simptom koji se javljao
u naših ALS bolesnika bio je slabost ekstremiteta (92,3%), dok je najrjeđi bio dispneja (23,1%).
62% naših ispitanika prezentirala se kombiniranom kliničkom prezentacijom s predominantnim
oštećenjem i GMN i DMN. 38% ispitanika prezentirala se oštećenjem isključivo DMN,
dok nijedan ispitanik nije imao kliničku prezentaciju izoliranog zahvaćanja GMN. 50%
ispitanika imalo je ekstremitete kao inicijalno zahvaćenu regiju te 46,2% ispitanika je imalo
bulbarnu regiju, dok je samo 1 ispitanik 3,8% imao inicijalno zahvaćenu respiratornu
muskulaturu. Analizom se pokazala se statistički značajna povezanost dobi sudionika i razine
kalija (P=0,034) te povezanost dobi sudionika (P=0,037) i dobi u kojoj je postavljena dijagnoza
(P=0,046) s CRP-om. Istraživanjem se pokazala statistički značajna razlika između muškaraca
i žena u razini natrija (P=0,041) te su žene imale veće razina natrija. Analizom hemoglobina
pokazala se statistički značajna povezanost razine hemoglobina i pozitivnih patoloških refleksa
(P=0,049). Analizom razina natrija se pokazala statistički značajna povezanost natrija
s disfagijom (P=0,047) i fascikulacijom jezika (P=0,001).
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Zaključci: U pacijenata oboljelih od ALS-a mogu se vidjeti nespecifična odstupanja u
laboratorijskim parametrima. Ovim istraživanjem nije utvrđena specifična povezanost rutinskih
laboratorijskih parametara sa spolom, dobi pri postavljanju dijagnoze i kliničkom
prezentacijom ALS-a. Laboratorijski parametri (kreatinin, kreatin kinaza, albumini, lipidi,
elektroliti, hemoglobin i CRP) za sada se ne mogu koristiti kao potencijalni biomarkeri za ALS
te su zbog brojnih ograničenja ovog istraživanja nužna daljnja istraživanja. |
| Sažetak (engleski) | Objectives: The main aim of this study was to show changes in routine blood laboratory tests
and to examine the association of these changes with demographic variables and clinical
presentation of ALS patients.
Subjects and methods: The research was conducted in Department of Neurology at University
Hospital of Split in the form of a retrospective cohort study. The study included 26 ALS patients
with blood laboratory parameters that were routinely taken for the purpose of patient treatment.
The data were collected from the archives of the Department of neurology at University
Hospital of Split from the period of 2017 to 2021. The collected findings included data on
gender, age, age at diagnosis, initially affected body region, clinical presentation and data about
blood laboratory findings. The obtained results were presented with the help of absolute and
relative numbers, and the statistical association was interpreted at the significance level of
P<0.05 and P<0.01.
Results: 15 (57%) men and 11 (43%) women participated in this research. The age range of the
patients was from 37 to 91 years. The average age of the participants was 68.58, while the
average age at diagnosis was 64.12. The most common symptom that occurred in our ALS
patients, it was limb weakness (92.3%), while dyspnea was the least common (23.1%). 62% of
our subjects presented with a combined clinical presentation with predominant damage to both
GMN and DMN. 38% of respondents presented with damage exclusively to the DMN, while
no subject had a clinical presentation of isolated GMN involvement. 50% of subjects had
extremities as the initially affected region and 46.2% of subjects had bulbar region, while only
1 subject 3.8% had respiratory musculature initially affected. The analysis showed a statistically
significant association between the participant's age and potassium level (P=0.034) and the
association between the participant's age (P=0.037) and the age at which the diagnosis was
made (P=0.046) with CRP. The research showed a statistically significant difference between
men and women in sodium levels (P=0.041), and women had higher sodium levels. Analysis
of hemoglobin showed a statistically significant association between hemoglobin level and
positive pathological reflexes (P=0.049). Analysis of sodium levels showed a statistically
significant association of sodium with dysphagia (P=0.047) and tongue fasciculation (P=0.001).
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Conclusions: Non-specific abnormalities in laboratory parameters can be observed in ALS
patients. This research has not determined the specific association of routine laboratory
parameters with gender, age at diagnosis and clinical presentation of ALS. Laboratory
parameters (creatinine, creatine kinase, albumins, lipids, electrolytes, hemoglobin and CRP)
cannot currently be used as potential biomarkers for ALS, and due to numerous limitations of
this study, further research is necessary. |
