ALS multidisciplinary clinic and survival
ALS multidisciplinary clinic and survival
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ALS 多学科临床和生存
作者：
S. Zoccolella;E. Beghi;G. Palagano;A. Fraddosio;V. Guerra;V. Lepore;I. Simone;P. Lamberti;L. Serlenga;G. Logroscino
肌萎缩侧索硬化（Amyotrophiclateralsclerosis，ALS）是一种影响运动神经元的神经退行性疾病，目前尚无有效的治疗方法。由于ALS的损伤和残疾的多因素性质，多学科诊所（MDC）最近已被引入ALS患者的管理;然而，它们对生存的影响仍然存在，目的比较在MDC接受护理的ALS患者与在普通神经科诊所接受护理的患者的生存率。1997年在意大利南部的普利亚建立了ALS登记处。我们检查了126的130事件ALS病例中的生存在1998- 99年期间被诊断。结果84例（67%）的患者被纳入并遵循MDC和其余42例（33%）的一般神经科诊所。在ALS多学科（17.6个月）和普通诊所（18个月）随访的患者之间，从诊断开始的中位生存时间没有差异。在延髓型ALS（11.7个月vs 23个月）中不存在有益效果。在多变量分析中，ALS MDC管理仅与12个月时生存概率增加10%相关（HR：0.91; 95%CI：0.44-1.89; p = 0.9）.ConclusionsIn this population based series，we found that in Southern意大利，ALS管理由多学科诊所不提高生存率，无论症状发作的部位。
BackgroundAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motorneurons, for which there is no effective cure. Because of the multifactorial nature of impairment and disablity in ALS, multidisciplinary clinics (MDC) have been recently introduced in the management of ALS patients; their effects on survival remain, however, largely debated.ObjectiveTo compare survival of ALS patients who received their care at MDC with that of patients followed by general neurology clinics.MethodsSource of the study was a prospective population-based registry of ALS established in Puglia, Southern Italy, in 1997. We examined survival of 126 out of 130 incident ALS cases that were diagnosed during the period 1998–99.Results84 patients (67%) were enrolled and followed by MDC and the remaining 42 (33%) by general neurological clinics. No difference in median survival time from the diagnosis was observed between patients followed by ALS multidisciplinary (17.6 months) and general clinics (18 months). No beneficial effect was present among bulbar onset ALS (11.7 versus 23 months). In multivariate analysis management by ALS MDC was associated with only a 10% increase in survival probability at 12 months (HR: 0.91; 95%CI: 0.44–1.89; p = 0.9).ConclusionsIn this population-based series, we found that in Southern Italy management of ALS by multidisciplinary clinics does not improve survival, regardless of site of symptoms onset.