{"title":"亚马逊地区周围神经病的模式、原因和功能结果。","authors":"Nathalie Deschamps, Mathieu Nacher, Pierre-Marie Preux, Valérie Takam, Romain Blaizot, Beatrice Cenciu, Nadia Sabbah, Bertrand De Toffol","doi":"10.1371/journal.pone.0315760","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Peripheral neuropathies have a wide variety of causes and pathophysiologies. Assuming that there are local particularities in the Amazon region, the aim of this study was to describe the characteristics of patients by determining the factors associated with functional severity.</p><p><strong>Methods: </strong>This was a retrospective observational study at Cayenne Hospital between January 2015 and May 2023. We included patients from the French hospital activity monitoring database \"Programme de médicalisation des systèmes d'information\" by searching for the keywords \"neuropathy\" \"Guillain-Barre syndrome\"(GBS) \"multineuritis\" \"polyneuritis\". The Peripheral Neuropathy Disability (PND) score was determined to quantify the functional severity of patients.</p><p><strong>Results: </strong>A total of 754 patients were included, with a mean age of 60 years (SD = 14.6) and a predominance of women (53.6%). Gait disorders were present in 16.3% of patients (PND between 2 and 4). Mortality was 14.3% at 3 years. The most common causes of neuropathy were diabetes (58.2%), chemotherapy induced polyneuropathy toxicity (21.5%), Guillain-Barre syndrome (6.0%), unlabeled (3.2%), and infectious causes (2.0%). Infectious causes mainly included HIV in 13 patients (43.3%) and leprosy in 8 patients (26.7%). Only GBS was significantly associated with functional severity but all patients with a deficiency had a severe score. But, after excluding GBS, infectious causes were significantly associated with a severe PND score (aOR = 3.69 [1.18-11.58]).</p><p><strong>Discussion: </strong>The characteristics of French Guiana combine those found in developed and developing countries, with an over-representation of infections (notably HIV and leprosy), and diabetes. The causes often result from social inequalities in health.</p><p><strong>Conclusion: </strong>This is the first comprehensive study of the diverse causes of neuropathy in a territory undergoing epidemiologic transition in the Amazon region.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"19 12","pages":"e0315760"},"PeriodicalIF":2.9000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661610/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pattern, causes and functional outcome of peripheral neuropathies in the Amazon region.\",\"authors\":\"Nathalie Deschamps, Mathieu Nacher, Pierre-Marie Preux, Valérie Takam, Romain Blaizot, Beatrice Cenciu, Nadia Sabbah, Bertrand De Toffol\",\"doi\":\"10.1371/journal.pone.0315760\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Peripheral neuropathies have a wide variety of causes and pathophysiologies. Assuming that there are local particularities in the Amazon region, the aim of this study was to describe the characteristics of patients by determining the factors associated with functional severity.</p><p><strong>Methods: </strong>This was a retrospective observational study at Cayenne Hospital between January 2015 and May 2023. We included patients from the French hospital activity monitoring database \\\"Programme de médicalisation des systèmes d'information\\\" by searching for the keywords \\\"neuropathy\\\" \\\"Guillain-Barre syndrome\\\"(GBS) \\\"multineuritis\\\" \\\"polyneuritis\\\". The Peripheral Neuropathy Disability (PND) score was determined to quantify the functional severity of patients.</p><p><strong>Results: </strong>A total of 754 patients were included, with a mean age of 60 years (SD = 14.6) and a predominance of women (53.6%). Gait disorders were present in 16.3% of patients (PND between 2 and 4). Mortality was 14.3% at 3 years. The most common causes of neuropathy were diabetes (58.2%), chemotherapy induced polyneuropathy toxicity (21.5%), Guillain-Barre syndrome (6.0%), unlabeled (3.2%), and infectious causes (2.0%). Infectious causes mainly included HIV in 13 patients (43.3%) and leprosy in 8 patients (26.7%). Only GBS was significantly associated with functional severity but all patients with a deficiency had a severe score. But, after excluding GBS, infectious causes were significantly associated with a severe PND score (aOR = 3.69 [1.18-11.58]).</p><p><strong>Discussion: </strong>The characteristics of French Guiana combine those found in developed and developing countries, with an over-representation of infections (notably HIV and leprosy), and diabetes. 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引用次数: 0
摘要
背景:周围神经病变有各种各样的病因和病理生理。假设亚马逊地区存在当地的特殊性,本研究的目的是通过确定与功能严重程度相关的因素来描述患者的特征。方法:这是一项2015年1月至2023年5月在卡宴医院进行的回顾性观察研究。我们通过搜索关键词“神经病变”“格林-巴利综合征”(GBS)纳入了法国医院活动监测数据库“Programme de msamdicalisation des systems - mes d'information”中的患者。“multineuritis”“多神经炎”。周围神经病变功能障碍(PND)评分用于量化患者的功能严重程度。结果:共纳入754例患者,平均年龄60岁(SD = 14.6),以女性为主(53.6%)。16.3%的患者存在步态障碍(PND在2至4岁之间)。3年时死亡率为14.3%。最常见的神经病变原因是糖尿病(58.2%),化疗引起的多神经病变毒性(21.5%),格林-巴利综合征(6.0%),未标记(3.2%)和感染性原因(2.0%)。感染原因主要为艾滋病13例(43.3%),麻风病8例(26.7%)。只有GBS与功能严重程度显著相关,但所有缺乏症患者都有严重评分。但是,在排除GBS后,感染性原因与严重PND评分显著相关(aOR = 3.69[1.18-11.58])。讨论:法属圭亚那的特点结合了发达国家和发展中国家的特点,即感染(特别是艾滋病毒和麻风病)和糖尿病的比例过高。其原因往往是健康方面的社会不平等。结论:这是首次在亚马逊地区流行病学转变的地区对神经病变的多种原因进行综合研究。
Pattern, causes and functional outcome of peripheral neuropathies in the Amazon region.
Background: Peripheral neuropathies have a wide variety of causes and pathophysiologies. Assuming that there are local particularities in the Amazon region, the aim of this study was to describe the characteristics of patients by determining the factors associated with functional severity.
Methods: This was a retrospective observational study at Cayenne Hospital between January 2015 and May 2023. We included patients from the French hospital activity monitoring database "Programme de médicalisation des systèmes d'information" by searching for the keywords "neuropathy" "Guillain-Barre syndrome"(GBS) "multineuritis" "polyneuritis". The Peripheral Neuropathy Disability (PND) score was determined to quantify the functional severity of patients.
Results: A total of 754 patients were included, with a mean age of 60 years (SD = 14.6) and a predominance of women (53.6%). Gait disorders were present in 16.3% of patients (PND between 2 and 4). Mortality was 14.3% at 3 years. The most common causes of neuropathy were diabetes (58.2%), chemotherapy induced polyneuropathy toxicity (21.5%), Guillain-Barre syndrome (6.0%), unlabeled (3.2%), and infectious causes (2.0%). Infectious causes mainly included HIV in 13 patients (43.3%) and leprosy in 8 patients (26.7%). Only GBS was significantly associated with functional severity but all patients with a deficiency had a severe score. But, after excluding GBS, infectious causes were significantly associated with a severe PND score (aOR = 3.69 [1.18-11.58]).
Discussion: The characteristics of French Guiana combine those found in developed and developing countries, with an over-representation of infections (notably HIV and leprosy), and diabetes. The causes often result from social inequalities in health.
Conclusion: This is the first comprehensive study of the diverse causes of neuropathy in a territory undergoing epidemiologic transition in the Amazon region.
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