血糖漂移对糖尿病患者心肌损伤的机制研究

Study of glycemic excursion on the mechanism of myocardial injury in diabetic patients

糖尿病心肌病变是一种以心肌结构和功能异常为特征的疾病,其发病机制包括心肌糖脂代谢紊乱、氧化应激、炎症反应、内质网应激及心肌微血管病变等。影响糖尿病心肌病变发生、发展的因素很多。研究显示,血糖漂移亦可引起同样的病理、生理改变,且多项研究支持血糖漂移异常与心血管不良预后密切相关。但血糖漂移如何导致心肌的损伤尚需进一步明确。该文主要从上述几个方面综述血糖漂移对糖尿病心肌损伤的可能机制,为延缓糖尿病心肌病变提供依据。

Diabetic cardiomyopathy is a disease characterized by abnormal changes in myocardial structure and function. Its pathogenesis includes disorder of glycolipid metabolism, oxidative stress, inflammatory reaction, endoplasmic reticulum stress, myocardial microangiopathy and so on. There are many factors affecting the occurrence and development of diabetic cardiomyopathy. Studies have shown that glycemic excursion can cause the same pathophysiological changes, and there have been several studies supporting glycemic excursion abnormalities closely related to poor cardiovascular outcomes. However, the mechanism by which glycemic excursion causes myocardial damage needs to be further clarified. This article will mainly review the possible mechanisms of glycemic excursion for diabetic myocardial injury from the above aspects, so as to provide a theoretical basis for delaying diabetic cardiomyopathy.