眼瞼黄色腫の臨床的研究

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書誌事項

タイトル別名
  • ガンケン オウショクシュ ノ リンショウテキ ケンキュウ
  • Clinical Study on Xanthoma Palpebrarum
  • 原著

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説明

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昭和44年から49年までの6年間に千葉大皮膚科を受診した眼瞼黄色腫63例,それ以外の黄色腫15例につき,cholesterol, triglyceride, preparative ultracentrifuge法によるlipoprotein analysisおよび一般検査(耳血,肝機能,検尿など)を施行して次の結果をえた。1)眼瞼黄色腫は中年女子上眼瞼内側に好発する(男:女比=1:4.7,30〜40才台73%,両側上眼瞼内側60%)。2)腫瘤は発生より受診までの期間が長いほど大きなものが多く,漸次拡大していると考えられた。3)脂質検査した53例中23例43%に高脂血症を認め,うちType II型15例(65%),Type III型4例,続発性(糖尿病,肝疾患,ステロイド内服)を疑われるもの4例であり,正脂血症例中にγ-globulinの亢進(3例),紅皮症の合併(1例),肝炎後(1例)があった。4)眼瞼黄色腫の大きさとcholesterol,腫瘤の大きさの予後とcholesterolの関係につき検討したが,いずれも有意な結果をえられなかった。5)それ以外の黄色腫15例中11例73%に眼瞼黄色腫の合併があり,Type II型では9例中6例67%にみられ,Type III型,plane xanthomatosis,続発性のものにもみられた。以上より眼瞼黄色腫は種々の原因で起る黄色腫の1つのsignであり,高脂血症例ではType II型が多いことを述べた。

The author studied on the clinical characteristics of xanthoma palpebrarum and their relations with the serum lipid level. For 78 patients with xanthoma who were seen during the 6 year period from 1969 to 1974 at the Department of Dermatology, Chiba University, following tests were performed: 1) the lipoprotein analysis by the preparative ultracentrifuge method, 2) the quantitative estimation of serum cholesterol and triglyceride, and 3) the routine examinations for blood, urine and liver function. Sixty-three cases had xanthoma palpebrarum and 15 had the other type of xanthoma. The following result were obtained. 1) Middle-aged woman had a high incidence of xanthoma palpebrarum. The predilection site was the inside of the upper eyelid. 2) The tumor became gradually larger after onset. 3) Twenty-three of 53 cases (43%) who received lipid analysis, showed hyperlipemia. They were 15 cases (65%) of Type II, 4 of Type III, and 4 of secondary hyperlipemia caused by diabetes mellitus, hepatic disorders and steroid therapy. In normolipemic group there were 3 cases with hyper-γ-globulinemia, one with erythroderma and one having the history of hepatitis. 4) There was no significant relationship between the tumor size of xanthoma palpebrarum or its growth and the serum cholesterol level. 5) The association of the other types of xanthoma with xanthoma palpebrarum was observed in 11 cases (73%). They were 6 of 9 cases of Type II, 2 of Type III, 2 of plane xanthomatosis and one of secondary xanthomatosis. In conclusion, xanthoma palpebrarum is not simple and may have a great variety of background in lipid metabolism.

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