糖尿病患者冠状动脉微血管功能障碍的发病机制

Pathogenesis of Coronary Microvascular Dysfunction of Diabetic Patients

冠状动脉微血管功能障碍(CMD)指由多种致病因素导致的冠状动脉微循环结构和功能发生异常的临床综合征,是导致心肌缺血或其他不良心血管事件的发病机制之一,普遍存在于糖尿病患者。在高血糖状态下,机体经各种信号转导通路损害血管内皮功能、诱导氧化应激和细胞凋亡,它们可能与CMD的发生演变息息相关。但目前尚缺乏大量关于糖尿病与CMD关系的临床研究,致使糖尿病患者CMD的发生机制尚不明确,糖尿病患者CMD诊疗缺乏统一标准,对临床疾病的诊疗及预后有很大影响。因此,未来深入探索糖尿病患者CMD的发生、发展及演变规律具有重要意义。

Coronary microvascular dysfunction(CMD)refers to a clinical syndrome in which the structure and function of coronary microcirculation are abnormal due to a variety of pathogenic factors.It is one of the pathogenesis of myocardial ischemia or other adverse cardiovascular events,and generally exists in patients with diabetes mellitus.In a high glucose state,the body induces vascular endothelial impairment,oxidative stress and apoptosis through various signal transduction pathways,which may be closely related to the evolution of CMD.However,a large number of clinical studies on the relationship between diabetes and CMD are still lacking,resulting in the unclear mechanism of CMD in diabetic patients and a lack of unified standards for the diagnosis and treatment of CMD in diabetes,which have a great impact on the clinical diagnosis and prognosis of the disease.Therefore,it is of great significance to further explore the occurrence,development and evolution patterns of CMD in diabetic patients in the future.