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糖尿病心肌病( DCM)是糖尿病引发的一种慢性心肌病理改变。在这一慢性病理过程中,急性心肌反应如心肌细胞死亡起关键性的启动作用。除了高血糖,炎症反应也是引起糖尿病性心肌病心肌细胞死亡的一个重要因素。研究证实,糖尿病或肥胖经常可导致全身包括心脏中的肿瘤坏死因子-α( TGF-α) ,白介素-18和血小板激活抑制因子-1( PAI-1)的升高。这些细胞因子引起心肌细胞死亡的机制主要是与氧化和/或氮化损伤相关。金属硫蛋白做为一个有效的抗氧化剂,可以保护心肌免受氧化应激损伤以及细胞因子引发的心肌细胞死亡,从而有效地防止DCM的发生。应用特异性的超氧化抑制剂可以完全阻断细胞因子导致的心肌细胞死亡,所以抑制氧化应激可以有效防止心肌死亡。因此,糖尿病诱发的炎症因子通过氧化应激反应所诱发的心肌细胞死亡是糖尿病心肌病( DCM)发生发展中的重要始动因子。
Diabetic cardiomyopathy (DCM) is a chronic cardiomyopathy induced by diabetes. In this chronic pathological process, acute cardiac responses such as cardiomyocyte death play a key initiating role. In addition to hyperglycemia, the inflammatory response is also an important factor that causes cardiomyocyte death in diabetic cardiomyopathy. Studies have shown that diabetes or obesity can often lead to elevated levels of tumor necrosis factor-α (TGF-α), interleukin-18 and platelet-activating inhibitor-1 (PAI-1) in the whole body, including the heart. The mechanism by which these cytokines cause cardiomyocyte death is mainly associated with oxidative and / or nitrotic damage. As a potent antioxidant, metallothionein can protect myocardium from oxidative stress injury and cytokine-induced cardiomyocyte death, thereby effectively preventing the occurrence of DCM. Application of specific superoxide inhibitors can completely block cytokine induced cardiomyocyte death, so inhibition of oxidative stress can effectively prevent myocardial death. Therefore, the death of cardiomyocytes induced by diabetes-induced inflammatory factors through oxidative stress is an important factor in the development of diabetic cardiomyopathy (DCM).