糖尿病肾病肾小球硬化的机制研究进展

Research Progress of the Mechanism of the Glomerulosclerosis in Diabetic Kidney Disease

肾小球硬化是糖尿病肾病(DKD)病情进展的重要原因。血糖、血脂以及炎症紊乱是DKD的临床特点,这些因素均可引起DKD肾脏损伤。此外,外周血细胞释放的微粒、中性粒细胞释放的胞外染色质、激活的蛋白C、血栓调节蛋白调节的补体系统以及微RNA的变化会影响肾小球基膜的内皮细胞、足细胞以及系膜细胞的功能,并且增加纤维蛋白与补体复合物沉积在肾小球内的沉积,加速肾小球的损伤以及纤维化和硬化。了解DKD肾小球损伤的机制对于DKD的治疗有着重要意义。

Glomerulosclerosis plays an important role in the progression of diabetic kidney disease. The disorder of blood glucose, blood lipid and inflammation may cause renal injury, which are potentially involved in the development of diabetic kidney disease（DKD）. Recent studies have found that microparticles released from peripheral blood cell, extracellular chromatin released from neutrophil, activated protein C, thrombomod- ulin regulated complement system as well as microRNA could influence the function of glomerular endothelial cells, podocytes and mesangial ceils. In addition, they could also increase the deposition of fibrin and complement complex in the glomerulus. Better understanding of the mechanisms of glomerulosclerosis is beneficial to the treatment of DKD.