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无糖尿病的类脂质渐进性坏死(诊断与治疗可能性)

[Necrobiosis lipoidica without diabetes mellitus (diagnostic and therapeutic possibilities)].

作者信息

Császár A, Daróczy J, Szénási P, Anda L, Tóth L, Hosszúfalusi N, Karádi I, Kalabay L, Romics L

出版信息

Orv Hetil. 1989 Oct 1;130(40):2141-5.

PMID:2694055
Abstract

The goal of the present study was to follow the clinical behaviour of 6 non diabetic patients (5 females and 1 male, aged 23-68) suffering from necrobiosis lipoidica. Thickening of the basalmembrane of capillaries could be confirmed by electron microscopy, although the histological structure of skin alterations are not different from those observed in diabetes mellitus. Three patients (2 females and one male) showed impaired glucose tolerance, 2 other patients had increased levels of total cholesterol, whereas one patient suffered from both metabolic disturbances. After treatment with ASA (acetylsalicylic acid, 1.0 g/day) and dipyridamole (200 mg/day) for six weeks, the decrease of platelet in vitro aggregation in platelet rich plasma could be observed by stimulation with arachidonic acid, epinephrine, ADP and collagen, respectively. Healing of the exulceration of skin lesion could be detected by the use of the combined treatment of ASA and dipyridamole in 4 cases.

摘要

本研究的目的是追踪6例患有类脂质渐进性坏死的非糖尿病患者(5名女性和1名男性,年龄23 - 68岁)的临床行为。尽管皮肤病变的组织学结构与糖尿病患者中观察到的并无差异,但通过电子显微镜可确认毛细血管基底膜增厚。3例患者(2名女性和1名男性)表现出葡萄糖耐量受损,另外2例患者总胆固醇水平升高,而1例患者同时患有这两种代谢紊乱。在用阿司匹林(乙酰水杨酸,1.0克/天)和双嘧达莫(200毫克/天)治疗六周后,通过分别用花生四烯酸、肾上腺素、二磷酸腺苷和胶原蛋白刺激,可观察到富含血小板血浆中血小板体外聚集的减少。在4例患者中,使用阿司匹林和双嘧达莫联合治疗可检测到皮肤病变溃疡的愈合。

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