在ALS进展中的种族差异:在单个中心观察到的临床事件的时间
Shanshan Chen1, Demetrius Carter2, Jillian Prier2
1Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA.
Muscle & nerve
|March 11, 2025
概括
与非西班牙裔白人患者相比,患有肌缩侧面硬化症 (ALS) 的黑人患者在临床关键事件 (包括轮椅,非侵入性通风 (NIV),增强性和替代性沟通 (AAC) 和临终关怀转诊) 的时间显著更快.
科学领域:
- 神经学 神经学
- 健康差距 研究 研究 研究 研究
- 流行病学 流行病学
背景情况:
- 关于肌缩侧面硬化症 (ALS) 种族差异的先前研究主要集中在诊断延迟和疾病严重程度上.
- 种族与ALS临床关键事件的进展之间的时间关系尚未得到充分研究.
- 了解这些差异对于识别ALS患者疾病轨迹的差异至关重要.
研究的目的:
- 调查ALS的黑人和非西班牙裔白人患者在特定临床事件发生之前的种族差异.
- 为了比较一个单一中心队列内的不同种族群体之间的关键临床里程碑的时间.
主要方法:
- 从2017年到2023年,对33名黑人和170名非西班牙裔白人ALS患者进行了回顾性分析.
- 收集的数据包括诊断日期,轮椅转诊日期,非侵入性通风 (NIV),增强和替代通信 (AAC) 和临终关怀.
- 后勤回归和考克斯的比例危险模型被用来分析事件时间的种族差异,调整为共变量.
主要成果:
- 黑人患者在诊断前获得轮椅和NIV的几率明显更高.
- 在诊断后,黑人患者面临轮椅,NIV和AAC转诊的风险增加.
- 虽然黑人患者的宿舍转诊风险也更高,但这一发现在这个队列中没有达到统计学意义.
结论:
- 与非西班牙裔白人ALS患者相比,黑人临床关键事件发生的时间存在显著的种族差异.
- 这些发现表明,黑色ALS患者可能出现更先进的疾病或经历更快的疾病进展.
- 需要进一步的研究来阐明导致这些观察到的种族差异导致ALS进展的潜在机制.
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