Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study
Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study
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DOI：
10.1136/jnnp.2007.142430
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发表时间：
2008-07-01
影响因子：
11
通讯作者：
Latronico, N.
中科院分区：
文献类型：
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作者：
Guarneri, B.;Bertolini, G.;Latronico, N.
背景：危重病肌病（CIM）和多发性神经病（CIP）单独或联合使用（CIP/CIM）是重症监护病房（ICU）患者常见的并发症。没有证据表明区分 CIP 和 CIM 对患者预后有任何影响。方法：对 ICU 住院期间发生 CIP、CIM 或 CIP 和 CIM 联合的患者进行 1 年前瞻性队列研究。结果：92 名患者中有 28 名（30.4%）在 ICU 住院期间出现 CIP 和/或 CIM 电生理症状，其中 18 名患者在 ICU 出院时持续存在这种症状。出院时，15 名幸存者中的诊断结果为：6 例为 CIM，4 例为 CIP，3 例为 CIP 和 CIM 合并症，2 例不合作患者的诊断结果未确定。在对 6 名 CIM 患者进行为期 1 年的随访期间，1 名患者死亡，5 名患者在 3（3 名患者）至 6（2 名患者）个月内完全康复。三名 CIP/CIM 患者中，一名死亡，一名康复，一名残留 CIP 仍四肢瘫痪。 4 例 CIP 患者中，1 例康复，2 例持续肌无力，1 例仍处于四肢瘫痪状态。结论：CIM 的预后优于 CIP。鉴别诊断对于预测 ICU 患者的长期结果很重要。
Background: Critical illness myopathy (CIM) and polyneuropathy (CIP), alone or in combination (CIP/CIM), are frequent complications in patients in the intensive care unit (ICU). There is no evidence that differentiating between CIP and CIM has any impact on patient prognosis.Methods: 1-year prospective cohort study of patients developing CIP, CIM or combined CIP and CIM during ICU stay.Results: 28 out of 92 (30.4%) patients developed electrophysiological signs of CIP and/or CIM during their ICU stay, which persisted in 18 patients at ICU discharge. At hospital discharge, diagnoses in the 15 survivors were CIM in six cases, CIP in four, combined CIP and CIM in three and undetermined in two uncooperative patients. During the 1-year follow-up of six patients with CIM, one patient died and five recovered completely within 3 (three patients) to 6 (two patients) months. Of three patients with CIP/CIM, one died, one recovered and one with residual CIP remained tetraplegic. Of four patients with CIP, one recovered, two had persisting muscle weakness and one remained tetraparetic.Conclusion: CIM has a better prognosis than CIP. Differential diagnosis is important to predict long-term outcome in ICU patients.