Benhamou C L, Rouchon J P, Geslin N, Pierre D, Viala J F, Barthez J P
Presse Med. 1987 Jan 31;16(3):119-22.
During the last few years, articular symptoms have been reported in chronic renal failure patients on maintenance haemodialysis. A prospective study of arthropathies of the limbs was conducted in 73 such patients: 20 had experienced periarthritis, 32 had tendinous calcifications (3 or more in 16 cases), 29 had destructive arthropathies (especially of the hands) and 10 had calcium pyrophosphate dihydrate deposition. The periarthritis attacks were associated with the presence of tendinous calcifications. The destructive arthropathies could be due to calcium apatite microcrystal deposition, but the study provided no direct evidence of this mechanism. However, the pattern of erosive lesions, their location and their possible association with tendinous calcifications in the same joint were suggestive of calcium apatite deposition. Calcium pyrophosphate deposition, which affected the oldest patients, did not seem to be due to chronic renal failure treated with dialysis. The most important arthropathies were found in patients who had been haemodialysed for a long time, although the correlation was not statistically significant. The dialysis pattern did not seem to influence the articular disorders. There were more cases of calcification and periarthritis among patients whose phosphocalcium product (in mg) exceeded 6000, but the difference with other patients was not statistically significant. Periarthritis and arthropathies are truly disabling for these patients.
在过去几年中，已有报道称维持性血液透析的慢性肾衰竭患者出现关节症状。对73例此类患者进行了一项关于肢体关节病的前瞻性研究：20例有肩周炎，32例有肌腱钙化（16例有3处或更多处钙化），29例有破坏性关节病（尤其是手部），10例有二水焦磷酸钙沉积。肩周炎发作与肌腱钙化有关。破坏性关节病可能是由于磷灰石钙微晶沉积所致，但该研究未提供此机制的直接证据。然而，糜烂性病变的模式、其位置以及它们与同一关节中肌腱钙化的可能关联提示了磷灰石钙沉积。二水焦磷酸钙沉积影响年龄较大的患者，似乎并非由透析治疗的慢性肾衰竭所致。最重要的关节病见于长期接受血液透析的患者，尽管这种相关性无统计学意义。透析模式似乎不影响关节疾病。在钙磷乘积（以毫克计）超过6000的患者中，钙化和肩周炎的病例更多，但与其他患者的差异无统计学意义。肩周炎和关节病确实使这些患者丧失了劳动能力。
