Deposition of an amyloid-like substance as a possible complication of regular dialysis treatment.
Deposition of an amyloid-like substance as a possible complication of regular dialysis treatment.
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淀粉样蛋白样物质的沉积是常规透析治疗的可能并发症。
DOI：
10.1159/000407589
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发表时间：
1983
影响因子：
--
通讯作者：
K. Koch
中科院分区：
文献类型：
--
作者：
H. Kachel;P. Altmeyer;C. Baldamus;K. Koch
众所周知，在原发性和继发性淀粉样变性中，腕管是淀粉样蛋白沉积的好发部位，经常导致正中神经压迫，即所谓的腕管综合征(CTS)[3，11，17，18]。几位作者还描述了接受常规透析治疗(RDT)的患者CTS发生率增加[4，14，26]。没有观察到的病例报告有与CTS相关的潜在疾病，如淀粉样变性、类风湿性关节炎、糖尿病、原发性痛风、甲状腺功能减退症或其他病因[9，22]。与这些早期的发现相反，最近两个法国小组报告说，在总共15名因CTS而接受手术的RDT患者中，正中神经周围组织中的大多数都有淀粉样沉积[2，8]。由于这些患者都没有已知的与淀粉样变性相关的潜在疾病，也不能假定为原发性淀粉样变性，因此研究结果提示RDT或尿毒症与淀粉样变性的发生有关。为了进一步阐明这些问题，我们在我们自己的透析人群中进行了一项研究，试图回答以下问题：(1)RDT的时间与CTS的发生是否有关系？(2)在患有CTS的RDT患者的正中神经周围组织中是否可检测到淀粉样蛋白？(3)RDT患者的其他部位是否有淀粉样蛋白沉积？
It is well established that the carpal tunnel in primary and secondary amy-loidosis is a predilection site for amyloid deposition, leading frequently to a compression of the median nerve, ie, the so-called carpal tunnel syndrome (CTS)[3, 11, 17, 18]. Several authors also described an increased incidence of CTS in patients on regular dialysis treatment (RDT)[4, 14, 26]. None of the observed cases was reported to have an underlying disease known to be associated with CTS, such as amyloidosis, rheumatoid arthritis, diabetes mellitus, primary gout, hypothyreoidism, or other etiological factors [9, 22]. In contrast to these earlier findings, recently two French groups reported amyloid deposits in the perineural tissue of the median nerve in the majority of a total of 15 RDT patients who had been operated because of CTS [2, 8]. As none of these patients had an underlying disease known to be associated with amyloidosis, nor primary amyloidosis could be assumed, the findings suggest a relation between RDT or uremia and the occurrence of amyloidosis. To further clarify the issues, we carried out a study in our own dialysis population, trying to answer the following questions:(1) Is there a relationship between time on RDT and the occurrence of CTS?(2) Is amyloid detectable in the perineural tissue of the median nerve in RDT patients with CTS?(3) Is amyloid deposited at other sites in RDT patients?