Analysis Of Related Factors On The Condition And Progress Of Patients With Amyotrophic Lateral Sclerosis

Background and Objective: Amyotrophic lateral sclerosis(ALS)is a rare progressive neurodegenerative disease,which selectively invades the anterior horn cells of spinal cord,motor nuclei of brain stem,pyramidal cells of frontal cortex and pyramidal tract,resulting in the damage of upper and lower motor neurons.Its clinical manifestations are characterized by progressive muscular weakness of dominant voluntary muscles,muscular atrophy and pyramidal tract sign,and may be accompanied by dysarthria,dysphagia and dyspnea in the medulla oblongata.at present,The main mechanism of motor neuron degeneration is not clear.Infection,genetic factors,heavy metal poisoning,mitochondrial metabolism disorder,glutamate excitotoxicity,oxidative stress and neuroinflammation may be involved.ALS is lethal and highly disabling,and more patients die of respiratory failure in the late stage of the disease.Unfortunately,there is no specific treatment for this disease.At present,symptomatic support treatment is mainly aimed at prolonging the survival time,reducing complications and improving the quality of life.Only Riluzole and Edaravone have been proved to be able to prolong their survival time to a certain extent and have been approved for clinical application.Because the onset of ALS is easy to be ignored and there is no effective treatment,early identification and timely support treatment are very important for prolonging the survival time of ALS patients and improving life treatment.At present,the exploration of specific markers for diagnosis and prognosis of ALS has not made obvious progress.This paper will analyze the basic data and serological examination results of some patients with ALS,and explore the related factors of onset,condition and progress of ALS,so as to provide reference for early identification of high-risk groups and take intervention in time.Methods: The ALS patients in the First Affiliated Hospital of China Medical University from August 2019 to June 2022 were collected.According to the inclusion and exclusion criteria,suitable ALS patients were selected as the case group,and the healthy examinees in the physical examination center of the First Affiliated Hospital of China Medical University were randomly selected as the healthy control group.The basic clinical data and blood biochemical tests of patients were collected and analyzed by SPSS26.0.Single factor analysis was carried out between the ALS case group and the control group,and the factors with significant differences between the two groups were screened out,which were included in the binary logistics model to analyze the related factors of ALS.According to the ALSFRS-R score and disease progression rate,the patients were further divided into severe group and non-severe group,rapid progress group and slow progress group.The clinical data were analyzed by single factor,and the factors with significant differences were included in the binary logistic model to analyze the influencing factors of ALS condition and severity.By drawing the ROC curve of the subjects,the best cut-off values of these related factors were calculated.Results: 1.Basic characteristics of cases: A total of 66 patients with ALS were included in this study,including 43 males(65.2%)and 23 females(34.8%).The median APSFRS-R score was 36(29,41),and the average onset age was(60.26±8.79)years.The average onset age of females was higher than that of males,and the diagnosis delay time was 12(6,19)months.There were 47 patients(71.2%)with limb onset,and the diagnosis delay time of patients with bulbar onset was significantly shorter than that of patients with limb onset.There were 23 patients with smoking history(34.85%),16 patients with drinking history(24.24%),21 patients with hypertension(31.8%),10 patients with diabetes(15.2%)and 42 patients with diabetes(62%),42 cases(60.7%)had obviously lost weight by the time of seeing a doctor.2.The levels of body weight,BMI,WBC,Cys-c,TP,Cr,Hcy,ALB,Ur,T4 and T3 in ALS patients were significantly different from those in healthy people(P < 0.05),and the lower BMI,SCr and ALB were independently related to the onset of ALS.3.The ALSFRS-R score is positively correlated with the levels of SCr and UA,and there are significant differences in SCr,UA,weight loss and dysphagia between severe and non-severe ALS patients(P < 0.05).Low level of SCr and dysphagia are independently related to the severity of ALS,and the best cutoff value of SCr to reflect the severity of ALS is 52..4.There are significant differences between patients with rapidly progressing ALS and patients with slowly progressing ALS in terms of onset site,dysphagia,levels of Cr,PLR and vitamin B12(P < 0.05).High level of SCr,low PLR and dysphagia are independently related to the rapid progress of ALS,.Conclusion:1.ALS is more common in midium-elderly men,with the average age of onset in men being lower than that in women,and the delay in diagnosis in patients with ball onset is significantly shorter than that in patients with limb onset.2.BMI,SCr and ALB are correlated with ALS.2.SCR and dysphagia are independently related to the severity of ALS,and patients with SCR < 52 umol/L are more likely to be seriously ill.3.SCR,PLR and dysphagia are independently related to the rapid progress of ALS.When SCR > 47 umol/L and PLR<130,the patient’s condition is more likely to progress rapidly,and the best cutoff values of SCr and PLR to reflect the rapid progress of ALS are 47 and 130 respectively..