高敏性血小板与2型糖尿病

Hyper-reactive platelets and type 2 diabetes

2型糖尿病是一种进展性疾病,随着病程的发展,微血管及大血管并发症并不鲜见。冠心病、脑血管病变等大血管并发症引起的血栓事件是导致患者死亡的重要原因。2型糖尿病患者体内血管内皮损伤、凝血增强、纤溶障碍及高敏性血小板共同导致的血栓前状态与大血管并发症密切相关,高敏性血小板在其中发挥的作用不容忽视。2型糖尿病特征性的代谢异常包括高血糖、胰岛素抵抗和胰岛素缺乏、氧化应激、系统性炎症反应、肥胖及血脂异常。这些代谢异常共同作用诱导形成高敏性血小板,常规抗血小板药物对糖尿病患者体内这一特征性血小板的抑制作用有限。通过研究糖尿病患者体内高敏性血小板的形成机制可为糖尿病大血管并发症及心脑血管事件的预防提供新思路。

Type 2 diabetes mellitus is a progressive process. With the course of the disease progress,microvascular and macrovascular complications always happen. Thrombotic events caused by macrovascular complications, including coronary heart diseases and cerebrovascular diseases, are the main fatal factor for the patients with type 2 diabetes. Endothelial dysfunction, coagulative activation, impaired fibrinolysis, together with hyper-reactive platelets contribute to the diabetic prothrombotic state, which is strongly related to the macrovascular complications. In particular, the hyper-reactive platelets play a fundamental role among them. Type 2 diabetes is characterized by several metabolic dysfunctions such as hyperglycemia, insulin resistance and shortage, oxidative stress, systemic inflammation,obesity, and dyslipidemia. These metabolic dysfunctions work together to promote the formation of hyper-reactive platelets, which are distinctive in type 2 diabetes. The regular antiplatelet drugs, like aspirin, show limited inhibitory effect on them. Hence, studying the mechanism behind the hyper-reactive platelets could provide a brand-new view on the prevention of macrovascular complications and cardiovascular events in type 2 diabetes.