Hürter P, Berger M, Kubel R, Stolzenbach K, Zick R, Mitzkat H J
Monatsschr Kinderheilkd. 1983 Sep;131(9):582-6.
215 children and adolescents with insulin dependent diabetes (age: 12(6)/12 +/- 3(9)/12 yrs; duration of diabetes 4(5)/12 +/- 3(9)/12 yrs, daily insulin requirement: 0.74 +/- 0.26 I.U./kg b.w.) were investigated for the presence of hand changes (cheiropathy) due to diabetes. Controls were 110 healthy persons of similar age (age: 11(5)/12 +/- 4(8)/12 yrs). Signs of cheiropathy were found in 44 (20.5%) of the diabetics. In 28 of these diabetics reduced mobility of the proximal and/or distal interphalangeal joints of one finger and in 16 others of at least two fingers was observed. No pathological alterations were found in the wrists, shoulder joints or spine. Mild signs of cheiropathy were seen in 5 (4.5%) of the controls. A significant positive relationship was found between age and duration of diabetes and the severity of cheiropathy. Diabetics with cheiropathy also had significantly higher daily insulin requirements than others. Of 49 patients with good diabetic control only one (2.0%) had signs of cheiropathy. In the group of 82 diabetics with fair control 12 (14.6%) showed hand changes, in the group of 84 patients with poor control 31 (36.9%). Cheiropathy must be considered to be a prognostic indicator of impending microangiopathy (retinopathy, nephropathy and neuropathy) in diabetic children and adolescents.
对215名胰岛素依赖型糖尿病儿童和青少年（年龄：12（6）/12±3（9）/12岁；糖尿病病程4（5）/12±3（9）/12年，每日胰岛素需求量：0.74±0.26国际单位/千克体重）进行了调查，以确定是否存在糖尿病所致的手部改变（手部病变）。对照组为110名年龄相仿的健康人（年龄：11（5）/12±4（8）/12岁）。在44名（20.5%）糖尿病患者中发现了手部病变的体征。其中28名糖尿病患者的一根手指近端和/或远端指间关节活动度降低，另外16名患者至少两根手指出现这种情况。在腕关节、肩关节或脊柱未发现病理改变。5名（4.5%）对照组出现轻度手部病变体征。发现年龄、糖尿病病程与手部病变严重程度之间存在显著正相关。有手部病变的糖尿病患者每日胰岛素需求量也显著高于其他患者。在49名糖尿病控制良好的患者中，只有1名（2.0%）有手部病变体征。在82名控制一般的糖尿病患者组中，12名（14.6%）出现手部改变，在84名控制较差的患者组中，31名（36.9%）出现手部改变。手部病变必须被视为糖尿病儿童和青少年即将发生微血管病变（视网膜病变、肾病和神经病变）的预后指标。
