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1型和2型糖尿病患者手部软组织病变患病率增加:多种类型及相关意义

Increased prevalence of soft tissue hand lesions in type 1 and type 2 diabetes mellitus: various entities and associated significance.

作者信息

Renard E, Jacques D, Chammas M, Poirier J L, Bonifacj C, Jaffiol C, Simon L, Allieu Y

机构信息

Service d'Endocrinologie, Hôpital Lapeyronie, Montpellier, France.

出版信息

Diabete Metab. 1994 Nov-Dec;20(6):513-21.

PMID:7713273
Abstract

Sixty Type 1 (insulin dependent) and sixty Type 2 (non insulin dependent) diabetic patients attending a diabetology unit were examined in search of limited joint mobility, Dupuytren's disease, flexor tenosynovitis and carpal tunnel syndrome, in comparison with two populations of 60 non diabetic controls matched for sex and age with the Type 1 and the Type 2 diabetic patients. Microangiopathic and neuropathic complications, glycaemic control, blood pressure and tobacco consumption were simultaneously assessed in 39 of the 60 type 1 and in all the type 2 diabetic patients. The prevalence of the various soft tissue hand lesions was higher in both diabetic populations (respectively Type 1 and Type 2) than in their control populations: Limited joint mobility: 33.3 and 26.7% vs 5.0 and 8.3% (both p < 0.01); Dupuytren's disease: 35.0 and 30.0% vs 6.7 and 10.0% (both p < 0.01); flexor tenosynovitis: 23.3 and 16.7% vs 0.0 and 3.3% (p < 0.01 and p < 0.05); carpal tunnel syndrome: 26.7 and 15.0% vs 3.3 and 5% (p < 0.01 and NS). The prevalence of limited joint mobility in Type 1 diabetes was independently associated with increasing age (p < 0.05) and to lower extent with increasing duration of diabetes (p = 0.05), whereas the prevalence of Dupuytren's disease only correlated with increasing age in both types of diabetes (p < 0.05). In Type 2 diabetes, the prevalence of flexor tenosynovitis also increased independently with age (p < 0.05), and the prevalence of limited joint mobility increased in the opposite way to the body mass index after adjustment on age, duration of diabetes and sex (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一家糖尿病科,对60名1型(胰岛素依赖型)糖尿病患者和60名2型(非胰岛素依赖型)糖尿病患者进行了检查,以寻找关节活动受限、掌腱膜挛缩症、屈指肌腱腱鞘炎和腕管综合征,同时与两组分别与1型和2型糖尿病患者年龄和性别匹配的60名非糖尿病对照者进行比较。在60名1型糖尿病患者中的39名以及所有2型糖尿病患者中,同时评估了微血管病变和神经病变并发症、血糖控制、血压和吸烟情况。在两个糖尿病群体(分别为1型和2型)中,各种手部软组织病变的患病率均高于其对照群体:关节活动受限:分别为33.3%和26.7%,对照群体为5.0%和8.3%(均p<0.01);掌腱膜挛缩症:35.0%和30.0%,对照群体为6.7%和10.0%(均p<0.01);屈指肌腱腱鞘炎:23.3%和16.7%,对照群体为0.0%和3.3%(p<0.01和p<0.05);腕管综合征:26.7%和15.0%,对照群体为3.3%和5%(p<0.01和无显著性差异)。1型糖尿病中关节活动受限的患病率与年龄增加独立相关(p<0.05),与糖尿病病程增加的相关性较弱(p = 0.05),而在两种类型的糖尿病中,掌腱膜挛缩症的患病率仅与年龄增加相关(p<0.05)。在2型糖尿病中,屈指肌腱腱鞘炎的患病率也随年龄独立增加(p<0.05),在对年龄、糖尿病病程和性别进行调整后,关节活动受限的患病率与体重指数呈相反变化(p<0.05)。(摘要截选至250字)

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