| Sažetak | Cilj: Cilj istraživanja bio je utvrditi učestalost akutne upalne poliradikuloneuropatije u KBC-u Split u razdoblju od 2012. do 2016. godine.
Materijal i metode: Pretraživanjem arhive KBC-a Split pronađena su 54 bolesnika sa dijagnosticiranim sindromom Guillain-Barré. Isključeni pacijenti su oni koji boluju od kronične upalne demijelinizacijske polineuropatije i drugih neuroloških bolesti koje se očituju sa sličnim simptomima. Kod svakog bolesnika su promatrani sljedeći parametri: dob, spol, datum prijama na Kliniku za neurologiju, inačica akutne upalne poliradikuloneuropatije, MRC (Medical Research Council) ljestvica mišićne snage po prijamu i otpustu sa Klinike za neurologiju, postojanje prethodne respiratorne ili gastrointestinalne infekcije, protutijela na mogućeg uzročnika infekcije, trajanje hospitalizacije u danima, primijenjena terapija, ovisnost o umjetnoj ventilaciji, i kvaliteta mišićno-tetivnih refleksa (MTR). Kao izvor podataka o populaciji Splitsko-dalmatinske županije korišteni su rezultati popisa stanovništva RH iz 2011. godine. Statistička obrada podataka provedena je koristeći statistički paket IBM SPSS Statistics for Windows, verzija 23.0 (IBM, Armonk, NY).
Rezultati: Iz prikazanih rezultata može se uočiti da je učestalost GBS-a u KBC-u Split viša od prosječnih vrijednosti na razini RH i zapadnog svijeta (2.37 na 100 000 stanovnika). Najveći udio oboljelih čine osobe u dobi od 61 do 80 godina (40,74%). Bolest dominantno zahvaća muški spol, a najveći dio čini AUDP oblik GBS-a (72,22%). Na godišnjoj razini gledajući po mjesecima, najviše slučajeva je evidentirano u travnju i kolovozu. Najveći udio čine osobe čija je hospitalizacija trajala 12 dana, a nakon primjenjene terapije razvidno je značajno poboljšanje u kliničkoj slici prema parametru MRC ljestvice mišićne snage (na statističkoj razini srednja vrijednost 2.81 naprama 2.30, p˂0.001). Kvalitativnom analizom mišićno-tetivnih refleksa, AUDP i AMAN oblici GBS-a imaju najniže vrijednosti MTR. (srednja vrijednost MTR-a u AUDP-u je 0,49; u AMAN-u je 0,50). Osobe oboljele od AMAN oblika bolesti razvijaju tešku komplikaciju kliničke slike u smislu ovisnosti o umjetnoj ventilaciji (25%) u odnosu na ostale podvrste GBS-a. U većini slučajeva se radilo o infekciji koja je prethodila razvoju kliničke slike akutnog upalnog poliradikuloneuritisa.
Zaključak: Viša incidencija akutnog upalnog poliradikuloneuritisa se može objasniti time što KBC-u Split gravitira dio stanovništva naseljen u pograničnim općinama i županijama susjedne države Bosne i Hercegovine te tako utječe negativno na omjer broja potvrđenih slučajeva GBS-a i popisom utvrđenog broja stanovnika SDŽ. Treba spomenuti i značajnost SDŽ i grada Splita kao turističkog središta, što u ljetnom razdoblju može povećati broj slučajeva GBS-a koji čine ljudi koji nisu dio popisanog stanovništva SDŽ već se nalaze na godišnjem odmoru, a evidentirani su na Klinici za neurologiju kao potvrđeni slučajevi GBS-a. |
| Sažetak (engleski) | Objective: The aim of the study was to determine the incidence of acute inflammatory polyradiculoneuropathy in Clinical Hospital Centre Split in the period from 2012. to 2016.
Material and Methods: Upon searching archives of Clinical Hospital Centre Split, 54 patients with diagnosed Guillain-Barré syndrome have been found. Excluded patients are those who suffer from chronic inflammatory demyelinating polyneuropathy and other neurological diseases that are manifested with similar symptoms. The following parameters were observed for each patient: age, gender, date of admission to the Neurology Clinic, version of acute inflammatory polyradicular neuropathy, MRC (Medical Research Council) muscle strength scores at reception and discharge from the Neurology Clinic, previous respiratory or gastrointestinal infections, antibodies against the possible cause of infection, duration of hospitalization in days, applied therapy, artificial ventilation dependence, and quality of muscular-tendon reflexes (MTR). As a source of data on the population of the Split-Dalmatia County, the results of the 2011 census of the population of Croatia were used. Statistical data processing was performed using the statistical suite IBM SPSS Statistics for Windows, version 23.0 (IBM, Armonk, NY).
Results: It can be seen from the presented results that the frequency of GBS in Clinical Hospital Centre Split is higher than the average values at the level of the Republic of Croatia and the Western world (2.37 per 100 000 inhabitants). The largest proportion of people affected are 61 to 80 years of age (40.74%). The disease is dominated by male sex, and most of it forms the AIDP form of GBS (72.22%). On a yearly basis, looking at months, most cases were recorded in April and August. The largest share is made by persons whose hospitalization lasted for 12 days and after the applied therapy there is a marked improvement in the clinical picture according to the MRC scale of muscle strength (at the statistical level the mean value of 2.81 vs. 2.30, p˂0.001). Qualitative analysis of muscular-tendon reflexes, AIDP and AMAN forms of GBS have the lowest MTR values. (The average value of MTR in AIDP is 0.49, AMAN is 0.50). People suffering from AMAN disease develop a serious clinical complication in terms of artificial ventilation dependency (25%) compared to other GBS subtypes. In most cases, there was an infection that preceded the development of a clinical stage of of acute inflammatory polyradiculoneuropathy.
Conclusion: The higher incidence of acute inflammatory polyradiculoneuropathy can be explained by the fact that Clinical Hospital Centre Split is gravitating to a part of the population inhabited by border municipalities and counties of neighboring Bosnia and Herzegovina, thus adversely affecting the ratio of the number of confirmed GBS cases and the list of established Split-Dalmatia County population. It should be mentioned also the significance of the Split-Dalmatia County and the city of Split as a tourist center, which in the summer period may increase the number of GBS cases that make people who are not part of the Split-Dalmatia County population, they were on vacation and recorded at the Neurology Clinic as confirmed cases of GBS. |
