糖尿病性视网膜病变发病机制研究进展

An overview of the pathogenesis of diabetic retinopathy

糖尿病性视网膜病变(DR)是糖尿病最常见和最严重的微血管并发症之一,DR的病理特征为视网膜新生血管形成和BRB破坏,它是糖尿病患者视力丧失的主要原因。高血糖是糖尿病并发症发生和发展的重要危险因素,而糖尿病最终如何导致DR发病的机制十分复杂。长期的高血糖症导致氧化酶损伤,微血栓形成,细胞粘附分子活化,白细胞郁积和细胞因子活化,继之,缺氧调节的生长因子的表达增加和细胞因子的产生。在这个机制中起主要作用的因子为VEGF、IGF-1、TNF-α、IL-1β、FGF等。多种因子相互作用引起视网膜新生血管形成和血—视网膜屏障(BRB)破坏在DR的发生和发展中起着关键作用。本文通过文献回顾,综述了糖尿病性视网膜病变发病机制的研究进展。

Diabetic retinopathy （DR） is one of the most common and the most severe complications of diabetes mellitus （DM）, and it may induce blindness. The pathology characteristic of DR is the breakdown of the blood-retinal barrier and neovascularisation. Hyperglycaemia is an important factor in the development and progression of this disease. The pathogenesis of DR is very complex. Chronic hyperglycaemia leads to oxidative injury, microthrombi formation, cell adhesion molecule activation, leukostasis and cytokine activation. Then ischaemia-mediated overexpression of growth factors and cytokine occurs, in which VEGF, IGF-1, TNF-α, IL-1β, FGF play impotant roles. The breakdown of the blood-retinal barrier and neovascularisation induced by the interaction of many factorscause a great effect on the development and progression of DR. The research progress of the pathogenesis of DR is summarized in the present paper.