2型糖尿病弱化远端缺血预处理的心肌保护作用

Cardioprotection of Type 2 Diabetes with Weakened Remote Ischemic Preconditioning

2型糖尿病患者对一氧化氮舒张血管作用敏感性下降,微血管病变导致心肌的氧储备较差,新生血管不能有效形成等因素导致2型糖尿病患者发生心肌梗死后预后不佳。远端缺血预处理被证实具有保护心肌和缩小梗死面积的作用,然而2型糖尿病似乎弱化了远端缺血预处理的心肌保护作用,其原因可能是2型糖尿病患者体内长期受抑制的磷脂酰肌醇3-激酶/蛋白激酶B信号通路、血管舒张功能的减弱、氧化应激和炎症水平的长期升高、长期的自噬功能受抑制和自主神经病变。

The sensitivity of patients with type 2 diabetes to vasorelaxation effect of NO is decreased,microvascular disease leads to poor oxygen reserve of myocardium,and neovascularization cannot be effectively formed.All of these factors will lead to poor prognosis in patients with type 2 diabetes after myocardial infarction.Remote ischemic preconditioning has been proved to protect myocardium and reduce infarct size.However,type 2 diabetes seems to weaken the cardioprotection effect of remote ischemic preconditioning,which may be due to the long-term inhibition of PI3K/Akt signaling pathway,the weakening of vascular diastolic function,long-term increase in oxidative stress and inflammation,long-term inhibition of autophagy and autonomic neuropathy in patients with type 2 diabetes.