Caroli A, Marcuzzi A, Pasquali-Ronchetti I, Guerra D, Zanasi S
Hand Surgery Unit, University of Modena, Italia.
Ann Chir Main Memb Super. 1992;11(4):314-9. doi: 10.1016/s0753-9053(05)80479-x.
Because of the frequent presence of corneal arcus senilis in patients affected by Dupuytren's disease in order to evaluate this association, the authors conducted a biomicroscopic examination of the cornea in 336 patients treated surgically for Dupuytren's disease, at the Hand Surgery Unit of the University of Modena from November 1985 to December 1989. They observed corneal arcus senilis in 259 patients, i.e. in 77.1% of patients with Dupuytren's disease. Due to the statistically significant correlation between arcus senilis and hyperlipidemia as reported by Tschetter (1980) and Felder (1981), the Authors collected a blood sample from all 336 patients to evaluate serum cholesterol and tryglicerides. This study revealed a dyslipidemia in 54.8% of patients with Dupuytren's disease and in 60.2% of patients suffering from both Dupuytren's disease and arcus senilis. Because of the high frequency of dislipidemia in patients with Dupuytren's disease and arcus senilis, which are apparently two well-distinguished disease, the authors suggest that a lipid disorder may be a common aetiopathogenic factor. In particular, in favour of the possible role of hyperlipidemia in Dupuytren's disease, Electron Microscope Studies revealed lipid inclusions within fibroblasts and in the extracellular connective tissue of all pathologic palmar aponeurosis from 11 patients with Dupuytren's disease: these lipid inclusions were never seen in the normal aponeurosis taken from 5 control patients treated for traumatic palmar injuries.
由于在患有杜普伊特伦挛缩病的患者中角膜老年环的出现频率较高,为了评估这种关联,作者于1985年11月至1989年12月在摩德纳大学手外科对336例接受杜普伊特伦挛缩病手术治疗的患者进行了角膜生物显微镜检查。他们在259例患者中观察到角膜老年环,即占杜普伊特伦挛缩病患者的77.1%。由于Tschetter(1980年)和Felder(1981年)报道老年环与高脂血症之间存在统计学上的显著相关性,作者从所有336例患者中采集了血样以评估血清胆固醇和甘油三酯。这项研究显示,杜普伊特伦挛缩病患者中有54.8%存在血脂异常,同时患有杜普伊特伦挛缩病和角膜老年环的患者中有60.2%存在血脂异常。鉴于杜普伊特伦挛缩病患者和角膜老年环患者中血脂异常的高频率,这两种疾病显然是两种截然不同的疾病,作者认为脂质紊乱可能是一个共同的病因因素。特别是,支持高脂血症在杜普伊特伦挛缩病中可能作用的是,电子显微镜研究在11例杜普伊特伦挛缩病患者所有病理性掌腱膜的成纤维细胞内和细胞外结缔组织中发现了脂质包涵体:而在5例因手掌创伤接受治疗的对照患者的正常掌腱膜中从未见过这些脂质包涵体。