糖尿病视网膜病变发病机制及治疗的研究进展

Research Advances in Pathogenesis and Treatment of Diabetic Retinopathy

糖尿病视网膜病变(DR)是指由长期高糖引起的糖尿病患者视网膜局部微血管病理改变。DR的发生发展与遗传、代谢(血糖、血脂、血压)、糖尿病病程等因素密切相关。DR的发病机制复杂,主要涉及炎症、氧化应激、多元醇途径、己糖胺途径、细胞因子、肾素-血管紧张素系统等。DR的治疗手段多样(包括控制代谢紊乱、激光、手术治疗等),但疗效各异。目前先进的科学技术及研究手段均已应用于DR的诊疗,如人工智能应用于DR的筛查、预测和管理,全基因组学研究应用于DR的遗传性等方面。未来多组学联合探究DR的发病机制、构建防控体系以延缓DR发生发展,可为DR的治疗提供新思路。

Diabetic retinopathy(DR)refers to the pathological changes of local retinal microvascular caused by long-term high glucose in diabetes mellitus patients.The occurrence and development of DR are closely related to heredity,metabolism(blood glucose,blood lipid,blood pressure),the course of diabetes mellitus and other factors.The pathogenesis of DR is complex,mainly involving inflammation,oxidative stress,polyol pathway,hexosamine pathway,cytokines,renin-angiotensin system,etc.There are many treatment methods with different curative effects,mainly including control of metabolic disorders,laser treatment,surgical treatment,etc.At present,advanced technology and research methods are already applied in the diagnosis and treatment of DR,for example,artificial intelligence can be used for the screening,prediction and management of DR,the heritability of diabetes mellitus is mainly explored by whole genome association studies,and new drugs are explored.In the future,joint multi-omics will be applied to explore the pathogenesis of DR and build a prevention and control system to delay the occurrence and development of DR,providing new ideas for the treatment of DR.