Tsouli S G, Kiortsis D N, Argyropoulou M I, Mikhailidis D P, Elisaf M S
University of Ioannina, Greece.
Eur J Clin Invest. 2005 Apr;35(4):236-44. doi: 10.1111/j.1365-2362.2005.01484.x.
Tendon xanthomatosis often accompanies familial hypercholesterolaemia, but it can also occur in other pathologic states. Achilles tendons are the most common sites of tendon xanthomas. Low-density lipoprotein (LDL) derived from the circulation accumulates into tendons. The next steps leading to the formation of Achilles tendon xanthomas (ATX) are the transformation of LDL into oxidized LDL (oxLDL) and the active uptake of oxLDL by macrophages within the tendons. Although physical examination may reveal Achilles tendon xanthomas (ATX), there are several imaging methods for their detection. It is worth mentioning that ultrasonography is the method of choice in everyday clinical practice. Although several treatments for Achilles tendon xanthomas (ATX) have been proposed (LDL apheresis, statins, etc.), they target mostly in the treatment of the basic metabolic disorder of lipid metabolism, which is the main cause of these lesions. In this review we describe the formation, detection, differential diagnosis and treatment of ATX as well as the relationship between tendon xanthomas and atheroma.
肌腱黄色瘤病常伴有家族性高胆固醇血症，但也可发生于其他病理状态。跟腱是肌腱黄色瘤最常见的部位。循环中产生的低密度脂蛋白（LDL）在肌腱中蓄积。导致跟腱黄色瘤（ATX）形成的后续步骤是LDL转变为氧化型LDL（oxLDL）以及肌腱内巨噬细胞对oxLDL的主动摄取。虽然体格检查可能发现跟腱黄色瘤（ATX），但有几种影像学方法可用于检测它们。值得一提的是，超声检查是日常临床实践中的首选方法。虽然已提出多种治疗跟腱黄色瘤（ATX）的方法（LDL单采、他汀类药物等），但它们主要针对脂质代谢的基础代谢紊乱进行治疗，而脂质代谢紊乱是这些病变的主要原因。在本综述中，我们描述了ATX的形成、检测、鉴别诊断和治疗以及肌腱黄色瘤与动脉粥样硬化之间的关系。
