r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2019-24-5-21-31r-n-j-32Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ И НАБЛЮДЕНИЯCLINICAL RESEARCH AND SURVEILLANCEИсследование структуры коморбидности у пациентов с рассеянным склерозом с использованием валидированных опросниковThe study of comboridity in patients with multiple sclerosis using validated sels-report questionnaireshttps://orcid.org/0000-0001-9043-9823НеофидовН. А.NeofidovN. A.

Санкт-Петербург, 197110; Санкт-Петербург, 197022.

Neofidov Nikolay A.

Saint-Petersburg, 197110; Saint-Petersburg, 197022.

neofidoff@yandex.ruhttps://orcid.org/0000-0001-6831-0441МакшаковГ. С.MakshkovG. S.

Санкт-Петербург, 197110; Санкт-Петербург, 197022.

Saint-Petersburg, 197110; Saint-Petersburg, 197022.

https://orcid.org/0000-0002-7115-7123ЛазовскаяО. А.LazovskayaO. A.

Санкт-Петербург, 197022.

Saint-Petersburg, 197022.

https://orcid.org/0000-0002-6715-8203ТотолянН. А.TotolyanN. A.

Санкт-Петербург, 197022.

Saint-Petersburg, 197022.

https://orcid.org/0000-0001-7439-2690ШумилинаМ. В.ShumilinaM. V.

Санкт-Петербург, 197110; Санкт-Петербург, 197022.

Saint-Petersburg, 197110; Saint-Petersburg, 197022.

https://orcid.org/0000-0002-8006-237XЕвдошенкоЕ. П.EvdoshenkoE. P.

Санкт-Петербург, 197110.

Saint-Petersburg, 197110.

Санкт-Петербургский городской центр рассеянного склероза и АИЗ (ГБОУ Городская клиническая больница №31); Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Минздрава РоссииРоссияSPb Centre of Multiplesclerosis and AID (SBIH City Clinical Hospital No 31); Pavlov First Saint-Petersburg State Medical UniversityRussian FederationПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Минздрава РоссииРоссияPavlov First Saint-Petersburg State Medical UniversityRussian FederationСанкт-Петербургский городской центр рассеянного склероза и АИЗ (ГБОУ Городская клиническая больница №31)РоссияSPb Centre of Multiplesclerosis and AID (SBIH City Clinical Hospital No 31)Russian Federation2019150120202452131Copyright © Неофидов Н.А., Макшаков Г.С., Лазовская О.А., Тотолян Н.А., Шумилина М.В., Евдошенко Е.П., 20202020Неофидов Н.А., Макшаков Г.С., Лазовская О.А., Тотолян Н.А., Шумилина М.В., Евдошенко Е.П.Neofidov N.A., Makshkov G.S., Lazovskaya O.A., Totolyan N.A., Shumilina M.V., Evdoshenko E.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/32Введение

Введение. На долгосрочный прогноз рассеянного склероза (РС) влияют разные факторы, включая коморбидность. Цель исследования — изучить структуру коморбидности при рассеянном склерозе с помощью разработанного и валидированного специализированного опросника.

Материал и методы

Материал и методы. Обследуемые составили 2 группы из популяции Санкт-Петербурга: 885 пациентов с РС и 396 лиц контрольной  группы, 154 пациента предоставили  выписки из амбулаторных  карт. Специально разработанный опросник для самостоятельного заполнения обследуемыми включал демографические и антропометрические  показатели,  стандартные  вопросы о сопутствующих  заболеваниях  и информацию  об образе жизни. Для валидации опросника использовали данные из амбулаторной карты пациента. Валидация опросников выполнена методом каппа-статистики. Для оценки отношения шансов наличия коморбидности в каждой из групп использовался точный критерий Фишера.

Результаты

Результаты. Удовлетворительная и высокая согласованность информации (с каппа > 0,41) показана для артериальной гипертензии, ишемической болезни сердца, атеросклероза, сахарного диабета, увеита, псориаза, заболеваний щитовидной железы, бронхиальной астмы, мигрени и онкологических заболеваний.

У пациентов с РС распространенность  увеита, аутоиммунного  тиреоидита,  тревожности  и депрессии была выше, а хронической обструктивной болезни легких и ожирения ниже, чем в контрольной группе.

Выводы

Выводы. Разработанный опросник по ряду коморбидностей продемонстрировал высокую чувствительность и специфичность. В Санкт-Петербурге риск наличия сопутствующей патологии у пациентов с РС сопоставим с таковым в других регионах мира в сравнении с общей популяцией. Тревога и депрессия имеют больший риск выявления в группе молодых пациентов с РС, а аутоиммунные заболевания щитовидной железы — у пациентов среднего возраста и пожилых.

Introduction

Introduction. The long-term prognosis of multiple sclerosis (MS) is influenced by various factors, including comorbidity. The purpose of study is to investigate comorbidity in multiple sclerosis using the developed and validated specialized questionnaires.

Materials and methods

Materials and methods. The subjects comprised two groups from the population of St. Petersburg: 885 patients with MS and 396 the control group, 154 patients provided outpatient card medical records. A specially designed self-report questionnaire included demographic, anthropometric, lifestyle data, and standard questions on comorbidities. To validate the questionnaire, extracts from individual outpatient cards were analyzed. Validation of questionnaires was performed by mean of kappa statistics. To assess the odds of the presence of comorbidity in each group, Fisher’s exact test was used.

Results

Results. Satisfactory and high agreement of information (kappa> 0.41) revealed for arterial hypertension, ischemic heart disease, atherosclerosis, diabetes mellitus, uveitis, psoriasis, thyroid disease, bronchial asthma, migraine, and cancer. In MS patients, the prevalence of uveitis, autoimmune thyroiditis, anxiety and depression was higher, and chronic obstructive pulmonary disease and obesity prevalence was lower than in control group.

Discussion

Discussion. The developed questionnaire has demonstrated high sensitivity and specificity for a number of comorbidities. The risk of comorbidities in MS patients In St. Petersburg is comparable to that in other regions of the world. Anxiety and depression are of higher risk in the subgroup of younger patients with MS, and autoimmune thyroid disorders are of higher risk in middle-aged and elderly MS patients compared with the general population.

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The authors declare that there are no conflicts of interest present.