糖尿病与冠状动脉微循环障碍的研究进展

Research Progress in the Relationship between Coronary Microvascular Dysfunction and Diabetic Mellitus

糖尿病患者无论是否合并冠状动脉狭窄均常存在冠状动脉微循环障碍(CMD)。CMD可加重糖尿病患者的心肌缺血,增加糖尿病患者不良心血管事件的发生风险。糖尿病患者长期高血糖状态刺激介导内皮损害、氧化应激、炎症反应和血小板功能异常,与糖尿病合并CMD的发生、发展密切相关。侵入性和非侵入性的影像学方法可用于发现CMD,但不能显示其内在的发病机制。针对CMD相关发病机制的治疗方案也尚未经临床试验确证其疗效。探究糖尿病与CMD之间的关系有望为临床诊疗CMD提供新思路。

Coronary microvascular dysfunction(CMD)is often found in diabetes mellitus patients no matter whether they are complicated with concomitant coronary artery stenosis.CMD leads to more severe myocardial ischemia and increases the risk of adverse cardiovascular events in diabetic mellitus patients.Long-term hyperglycemia causes endothelial damage,oxidative stress,inflammatory response and abnormal platelet function,which are closely related to the occurrence and deve-lopment of CMD in diabetic mellitus.Invasive and noninvasive imaging methods are used to detect CMD,but cannot reveal its pathogenesis.The treatment of CMD aiming at its pathogenesis has not been confirmed its efficacy by clinical trials yet.Therefore,exploration of the relationship between diabetic mellitus and CMD may provide new clinical ideas for the diagnosis and treatment of CMD.