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[糖尿病与类脂质渐进性坏死关系的研究]

[Studies on the relationship between diabetes mellitus and necrobiosis lipoidica].

作者信息

Wiemers U, Hackel F, Voigt H

出版信息

Z Gesamte Inn Med. 1975 May 15;30(10):62-4.

PMID:1199249
Abstract

From 1970 to 1974 in the dermatological clinic of Leipig University in 17 women and 3 men a necrobiosis lipoidica was established. Of these patients hitherto 12 female patients with histologally ascertained diagnosis underwent a clinico-angiological follow-up examination. Apart from this metabolic disturbances were thought for. In two thirds a disturbance of the carbohypdrate metabolism, in three fourths a disturbance of the lipometabolism was found; hyperlipoproteidaemia and diabetic change of the metabolism were simultaneously present in 7 out of 12 female patients. Uric acid level of the serum and rheumatic serology were, however, rarely pathological. A disturbance of the arterial blood supply of the legs could be ascertained in three fourths of the women who underwent a control examination. In these cases 15 to 19 extremities affected with necrobiosis had a disturbance of the blood supply. The microangiopathy histologically provable in foci of necrobiosis was to be seen only in one long-term diabetic also on the eye-ground. One third of the female patients suffered from hypertension. In all cases disturbances of the carbohydrate metabolism or of the lipometabolism and/or of the local blood supply could be proved. On the basis of these findings adequate examinations are recommendable in patients with necrobiosis lipoidical with regard to therapeutic consequences.

摘要

1970年至1974年期间,莱比锡大学皮肤科诊所确诊了17名女性和3名男性患有类脂质渐进性坏死。迄今为止,对其中12名经组织学确诊的女性患者进行了临床血管造影随访检查。除此之外,还考虑了代谢紊乱情况。三分之二的患者存在碳水化合物代谢紊乱,四分之三的患者存在脂肪代谢紊乱;12名女性患者中有7名同时存在高脂蛋白血症和糖尿病代谢变化。然而,血清尿酸水平和风湿血清学检查结果很少出现异常。在接受对照检查的女性患者中,四分之三可确定存在下肢动脉血液供应紊乱。在这些病例中,15至19个受类脂质渐进性坏死影响的肢体存在血液供应紊乱。仅在一名长期糖尿病患者的眼底也发现了在类脂质渐进性坏死病灶中可通过组织学证实的微血管病变。三分之一的女性患者患有高血压。在所有病例中,均可证实存在碳水化合物代谢或脂肪代谢和/或局部血液供应紊乱。基于这些发现,对于患有类脂质渐进性坏死的患者,为了治疗效果,建议进行适当的检查。

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