SIGNIFICANCE OF TYPE-II FIBER ATROPHY IN CHRONIC-ALCOHOLIC MYOPATHY
SIGNIFICANCE OF TYPE-II FIBER ATROPHY IN CHRONIC-ALCOHOLIC MYOPATHY
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DOI：
10.1016/0022-510x(95)00005-m
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发表时间：
1995-05-01
影响因子：
4.4
通讯作者：
URBANOMARQUEZ, A
中科院分区：
文献类型：
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作者：
FERNANDEZSOLA, J;SACANELLA, E;URBANOMARQUEZ, A
为了确定酒精性肌病中II型纤维萎缩的意义及其与酒精相关疾病的关系，对100名临床疑似骨骼肌病变的慢性酒精中毒者进行了前瞻性研究。在每例病例中进行肌力测量、实验室分析、营养评估和三角肌开放活检，以及周围神经病变的电生理检查。对选定的受试者进行肝脏超声检查和肝活检、超声心动图和放射性核素心脏扫描。根据组织形态计量学分析，33例（33%）发现II型纤维萎缩，23例（70%）选择性II型B纤维。诊断为骨骼肌病变61例，酒精性心肌病26例，周围神经病变23例，肝硬化12例。与II型纤维萎缩的患者有一个显着较高的总剂量的乙醇，提出了一个更大的发病率骨骼肌病变和周围神经病变，并表现出显着较低的值的百分比的理想体重和瘦体重比他们的同行。然而，发展II型纤维萎缩的唯一独立因素是热量营养不良（p = 0.004）和骨骼肌病变（p = 0.043）的存在。选择性II型纤维萎缩是一种非特异性的发现，在酒精引起的肌肉损伤出现，总的来说，在患者的热量营养不良，以及在那些与肌病的组织学证据。
To determine the significance of type II fiber atrophy in alcoholic myopathy and its relationship with ethanol-related diseases a prospective study was carried out in 100 chronic alcoholics who showed clinical suspicion of skeletal myopathy. Measurement of muscle strength, laboratory analysis, nutritional assessment and open biopsy of deltoid muscle were performed in each case, as well as electrophysiological testing for peripheral neuropathy. Hepatic ultrasonography and liver biopsy, echocardiography and radionuclide cardiac scanning were carried out in selected subjects. According to histomorphometric analysis, type II fiber atrophy was found in 33 cases (33%), being selective for type II B fiber in 23 (70%). Skeletal myopathy was diagnosed in 61 cases, alcoholic cardiomyopathy in 26, peripheral neuropathy in 23 and cirrhosis in 12. Patients with type II fiber atrophy had a significantly higher total lifetime dose of ethanol, presented a greater incidence of skeletal myopathy and peripheral neuropathy, and exhibited significantly lower values of percentage of ideal body weight and lean body mass than their counterparts. However, the only independent factors for developing type II fiber atrophy were the coexistence of caloric malnutrition (p = 0.004) and the presence of skeletal myopathy (p = 0.043). Selective type II fiber atrophy is a non-specific finding in alcohol-induced muscle damage appearing, overall, in the patients with caloric malnutrition as well as in those with histologic evidence of myopathy.