糖尿病剖検例における血管障害

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  • Vascular Complications in Diabetic Autopsy Cases

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Diabetic autopsy cases were collected from the Annual Report of Pathological Autopsy Cases published by Japanese of Pathology for the year 1976-1978. 2089 primary diabetic cases were collected and the cause of death and pathoanatomical findings in various organs were analysed in these primary diabetic cases, and following results were obtained.<br>1) The main causes of death were cardiovascular diseases (43.1%), malignant neoplasma (22.6%), infections (16.2%), diabetic coma (1.9%) and hypoglycemia (0.3%).<br>2) In cardiovascular diseases, the leading cause was diabetic nephropathy (15.6%), followed by cerebral (14.6%) and coronary (10.5%) artery disease.<br>3) The frequency of arteriosclerotic cardiovascular diseases and malignant neoplasmas as cause of death increased with age. Diabetic nephropathy appeared as a cause of death in 3rd decade and the leading cause of death was diabetic nephropathy in 3rd decade (52%) and 4th decade (32%), and over 5th decade decreased with age. Cerebral vascular and coronary artery diseases increased with age and cerebral vascular disease was the leading cause of death over 6th decade.<br>4) In pathoanatomical findings, the frequencies of glomerulosclerosis, myocardial infarction, cerebral infarction and homorrhage were 40.9%. 17.2%, 15.6% and 7.0%, respectively. Myocrdial infarction and cerebral infarction were found in 4th decade and increased with age, while cerebral hemorrhage decreased over 6th decade with age. Diabetic glomerulosclerosis was found in the cases of 2nd decade and high frequencies of glomerulosclerosis were found in all decade and it was higher than those of other vascular lesions.<br>These results showed the characteristics in the causes of death of diabetics in Japan are a lower incidence of coronary artery disease and a high incidence of diabetic nephropathy.

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