糖尿病在冠脉微血管功能障碍中的作用机制

Mechanism of diabetes mellitus on coronary microvascular dysfunction

摘要:

糖尿病、冠状动脉粥样硬化性心脏病是当前常见的慢性疾病，糖尿病患者70%~80%死于心血管系统疾病。糖尿病患者除了存在心外膜冠状动脉粥样硬化和心肌细胞损害外，也存在冠状动脉微血管功能障碍。胰岛素抵抗、高血糖、氧化应激、炎症因子、游离脂肪酸等因素使NO生物利用度下降，导致内皮功能障碍。当机体发生内皮细胞损害时，也发生了血管重塑、缺氧诱导的血管舒张受损，共同导致冠脉微循环功能障碍。本研究旨在探讨糖尿病在冠脉微血管功能障碍中的作用机制。

Abstract:

Diabetes mellitus and coronary atherosclerotic heart disease are common chronic diseases at present. Patients with diabetes mellitus of 70%-80% die of cardiovascular system diseases. In addition to epicardial coronary atherosclerosis and myocardial cell damage，diabetic patients also have coronary microvascular dysfunction. Insulin resistance，hyperglycemia，oxidative stress，inflamma－tory factors and free fatty acids are going to decrease the bioavailability of NO，leading to endothelial dysfunction. When endothelial cells are damaged in the body，impaired vasodilation caused by vascular remodeling and hypoxia also occurs，co-working to lead to the coronary microcirculation dysfunction. We reviewed the advance and mechanism of diabetes mellitus in coronary microvascular dysfunction.