Chammas M, Bousquet P, Renard E, Poirier J L, Jaffiol C, Allieu Y
Department of Endocrinology, Lapeyronie University Hospital, Montpellier, France.
J Hand Surg Am. 1995 Jan;20(1):109-14. doi: 10.1016/S0363-5023(05)80068-1.
A comparative prospective study of 120 adult diabetics (60 insulin dependent, 60 non-insulin dependent) and 120 non-diabetic adults as controls showed significantly higher incidence of Dupuytren's disease, limited joint motion, carpal tunnel syndrome, and flexor tenosynovitis in the diabetic population. Of the diabetic patients one third had a mild non-progressive form of Dupuytren's disease, which commonly involved the long and ring rays. Limited joint motion was noted in a third of diabetics, and carpal tunnel syndrome was observed in 15-25%, and flexor tenosynovitis in about a fifth. Limited joint motion co-existed with Dupuytren's disease in 57% of insulin-dependent diabetics. Diabetic polyneuropathy was found in two thirds of insulin-dependent diabetics and in one third of non-insulin dependent diabetics. All these hand changes were more marked in insulin-dependent diabetics and they showed a positive correlation with increasing age of the patient, duration of the diabetes, and the presence of a microangiopathy.
一项针对120名成年糖尿病患者(60名胰岛素依赖型,60名非胰岛素依赖型)和120名非糖尿病成年对照者的比较性前瞻性研究表明,糖尿病患者中掌腱膜挛缩症、关节活动受限、腕管综合征和屈肌腱鞘炎的发病率显著更高。在糖尿病患者中,三分之一患有轻度非进行性掌腱膜挛缩症,通常累及示指和环指。三分之一的糖尿病患者存在关节活动受限,15% - 25%的患者出现腕管综合征,约五分之一的患者有屈肌腱鞘炎。在57%的胰岛素依赖型糖尿病患者中,关节活动受限与掌腱膜挛缩症并存。三分之二的胰岛素依赖型糖尿病患者和三分之一的非胰岛素依赖型糖尿病患者存在糖尿病性多发性神经病变。所有这些手部病变在胰岛素依赖型糖尿病患者中更为明显,并且与患者年龄增长、糖尿病病程以及微血管病变的存在呈正相关。