Pattern of spread and prognosis in lower limb-onset ALS.
Pattern of spread and prognosis in lower limb-onset ALS.
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DOI：
10.3109/17482960903420140
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
Talbot K
中科院分区：
文献类型：
--
作者：
Turner MR;Brockington A;Scaber J;Hollinger H;Marsden R;Shaw PJ;Talbot K
我们的目的是建立一个多变量模型中下肢发病ALS的扩散模式（对侧与同侧）及其对预后的贡献。在2001年至2008年牛津和谢菲尔德三级诊所前瞻性记录的109例下肢发病的散发性ALS患者中建立了传播模式。生存分析采用单变量Kaplan-Meier对数秩和多变量考克斯比例风险。研究的变量包括下一次肢体进展的时间、下一次进展的部位、症状发作时的年龄、性别、诊断潜伏期和利鲁唑的使用。初始进展发生在对侧腿部（76%）或同侧手臂（24%）。独立影响生存率的因素是下一个肢体进展的时间，症状发作时的年龄和诊断潜伏期。疾病进展时间作为一个预后因素与最初的扩散方向无关。在对死者的回归分析中，从症状发作开始的总生存期约为两年加上最初传播的时间间隔。总之，下肢发病ALS的进展率不受初始扩散是对侧肢体还是同侧手臂的影响。初始扩散的时间间隔是预测总生存率的一个强有力的因素，可用于促进决策和有效的护理计划。
Our objective was to establish the pattern of spread in lower limb-onset ALS (contra- versus ipsi-lateral) and its contribution to prognosis within a multivariate model. Pattern of spread was established in 109 sporadic ALS patients with lower limb-onset, prospectively recorded in Oxford and Sheffield tertiary clinics from 2001 to 2008. Survival analysis was by univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards. Variables studied were time to next limb progression, site of next progression, age at symptom onset, gender, diagnostic latency and use of riluzole. Initial progression was either to the contralateral leg (76%) or ipsilateral arm (24%). Factors independently affecting survival were time to next limb progression, age at symptom onset, and diagnostic latency. Time to progression as a prognostic factor was independent of initial direction of spread. In a regression analysis of the deceased, overall survival from symptom onset approximated to two years plus the time interval for initial spread. In conclusion, rate of progression in lower limb-onset ALS is not influenced by whether initial spread is to the contralateral limb or ipsilateral arm. The time interval to this initial spread is a powerful factor in predicting overall survival, and could be used to facilitate decision-making and effective care planning.
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影响因子：
14.5
作者：
Turner, MR;Hammers, A;Leigh, PN
通讯作者：
Leigh, PN
影响因子：
9.9
作者：
Wijesekera, L. C.;Mathers, S.;Leigh, P. N.
通讯作者：
Leigh, P. N.
影响因子：
14.5
作者：
HAVERKAMP, LJ;APPEL, V;APPEL, SH
通讯作者：
APPEL, SH
影响因子：
9.9
作者：
WOHLFART, G
通讯作者：
WOHLFART, G
DOI：
10.3109/17482960802566824
发表时间：
2009-10
期刊：
Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases
影响因子：
--
作者：
Chiò A;Logroscino G;Hardiman O;Swingler R;Mitchell D;Beghi E;Traynor BG;Eurals Consortium
通讯作者：
Eurals Consortium