Attali P, Ink O, Pelletier G, Vernier C, Jean F, Moulton L, Etienne J P
Arch Intern Med. 1987 Jun;147(6):1065-7.
This prospective study was undertaken to assess the prevalence of Dupuytren's contracture (DC) and its relationship with possible causes, especially alcohol consumption and chronic liver disease. Four hundred thirty-two consecutively hospitalized patients were examined for evidence of DC. They were divided into five groups based on the following clinical, biologic, and histologic criteria: alcoholic cirrhosis (89 patients), noncirrhotic alcoholic liver disease (55 patients), chronic alcoholism without liver disease (46 patients), nonalcoholic chronic liver disease (68 patients), and a control group (174 patients). The prevalence of DC in these five groups of patients was 32.5%, 22%, 28%, 6%, and 12%, respectively; the prevalence of DC was higher in patients with cirrhotic or noncirrhotic alcoholic liver disease (25.5%) than it was in patients with nonalcoholic liver disease (6%), but it was not significantly different in alcoholic patients with or without liver disease. The relationship between DC and age, sex, manual labor, previous hand injuries, diabetes mellitus, alcohol consumption, and cigarette smoking was assessed by univariate and logistic regression methods. Nine variables were significantly different in patients with or without DC: age, sex, manual labor, previous hand injuries, diabetes mellitus, daily alcohol consumption, duration of alcohol consumption, total alcohol consumption, and duration of cigarette smoking. In our patients, variables that could explain DC were, in decreasing order, age, total alcohol consumption, sex (male), and previous hand injuries. In alcoholic patients, these variables were age and previous hand injuries; in nonalcoholic patients, these variables were age and cigarette smoking. These results emphasize the high prevalence of DC in alcoholic patients and the absence of a correlation between DC and chronic liver disease. Age and alcohol consumption are the best explanatory variables of DC in hospitalized patients.
本前瞻性研究旨在评估杜普伊特伦挛缩症（DC）的患病率及其与可能病因的关系，尤其是饮酒和慢性肝病。对432例连续住院患者进行了DC证据检查。根据以下临床、生物学和组织学标准将他们分为五组：酒精性肝硬化（89例患者）、非肝硬化酒精性肝病（55例患者）、无肝病的慢性酒精中毒（46例患者）、非酒精性慢性肝病（68例患者）和对照组（174例患者）。这五组患者中DC的患病率分别为32.5%、22%、28%、6%和12%；肝硬化或非肝硬化酒精性肝病患者中DC的患病率（25.5%）高于非酒精性肝病患者（6%），但有或无肝病的酒精性患者之间无显著差异。通过单因素和逻辑回归方法评估了DC与年龄、性别、体力劳动、既往手部损伤、糖尿病、饮酒和吸烟之间的关系。有或无DC的患者中有九个变量存在显著差异：年龄、性别、体力劳动、既往手部损伤、糖尿病、每日饮酒量、饮酒持续时间、总饮酒量和吸烟持续时间。在我们的患者中，能够解释DC的变量按降序排列为年龄、总饮酒量、性别（男性）和既往手部损伤。在酒精性患者中，这些变量是年龄和既往手部损伤；在非酒精性患者中，这些变量是年龄和吸烟。这些结果强调了酒精性患者中DC的高患病率以及DC与慢性肝病之间不存在相关性。年龄和饮酒量是住院患者中DC的最佳解释变量。
