Shchudlo N A, Stupina T A, Varsegova T N, Shchudlo M M, Kirsanova A J, Kostin V V
G.A.Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopaedics», 6 M.Ulyanovoi str., Kurgan 640014, Russian Federation, e-mail:
Adv Gerontol. 2019;32(5):812-818.
For the purpose of comparative analysis of the clinical course of fascial fibromatosis and tissue composition of the palmar aponeurosis in patients of different age groups сase reports and histological surgical material from 179 Dupuytren's contracture patients treated in 2014-2018 were analyzed. Patients were distributed in age groups: the 1st - younger than 50 years, the 2nd - 50-65 years, the 3rd - over 65 years old. In all groups four variants of Dupuytren's contracture clinical course were noted: swift, fast, benign and deffered. The rates of third-fourth levels of contracture in age groups were 50, 54 and 76% respectively. In groups 2 and 3 the volume per cents of hyperplastic connective tissue and adipocytes in palmar aponeurosis were decreased though body mass indexes were increased in comparison with group 1 (p<0,005). The signs of fat tissue vascularity and perivascular inflammatory infiltration were most pronounced in group 1, in group 3 per cent of vessels with adventitial fibrosis was significantly increased. The obtained data may be used for age-oriented treatment protocols and individual prognosis of fascial fibromatosis recurrence and spread.
为了比较不同年龄组患者筋膜纤维瘤病的临床病程以及掌腱膜的组织构成,我们分析了2014年至2018年期间接受治疗的179例杜普伊特伦挛缩患者的病例报告和组织学手术材料。患者按年龄分组:第一组——年龄小于50岁,第二组——50至65岁,第三组——年龄超过65岁。在所有组中均观察到杜普伊特伦挛缩临床病程的四种变体:迅速型、快速型、良性型和延迟型。各年龄组中第三至四级挛缩的发生率分别为50%、54%和76%。与第一组相比,第二组和第三组掌腱膜中增生性结缔组织和脂肪细胞的体积百分比降低,尽管体重指数有所增加(p<0.005)。脂肪组织血管化和血管周围炎性浸润的迹象在第一组最为明显,在第三组,伴有外膜纤维化的血管百分比显著增加。所获得的数据可用于制定针对不同年龄的治疗方案以及预测筋膜纤维瘤病复发和扩散的个体预后。