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目的综述糖尿病心肌病(diabetic cardiomyopathy,DCM)与肾素-血管紧张素系统(renin-angiotensin system,RAS)的关系及其药物治疗进展。方法依据近年来国内外相关文献报道,进行归纳分析和分类总结。结果与结论糖尿病时RAS被激活,升高的血管紧张素Ⅱ(angiotensionⅡ,AngⅡ)通过细胞表面的AT1受体,刺激心肌成纤维细胞增生及胶原代谢改变,引起心脏结构重塑,导致心肌间质及血管周围纤维化,心室肌僵硬而影响舒张功能,出现DCM的临床症状。RAS的主要成分AngⅡ、Ang-(1-7)、Ac-SDKP和血管紧张素受体(angiotension receptor,ATR)在糖尿病心肌病的发生发展过程中起重要作用,血管紧张素转换酶抑制剂(angiotensin-converting enzyme inhibitor,ACEI)及血管紧张素Ⅱ受体阻断剂(angiotensionⅡreceptor bloc-ker,ARB)则对DCM具有一定防治效应。
Objective To summarize the relationship between diabetic cardiomyopathy (DCM) and renin-angiotensin system (RAS) and the progress of drug therapy. Methods Based on the reports of relevant literature both at home and abroad in recent years, the author summarizes and summarizes the results. RESULTS AND CONCLUSION RAS was activated during diabetes mellitus. Elevated angiotensin Ⅱ (AngⅡ) stimulated cardiac fibroblast proliferation and collagen metabolism through the AT1 receptor on the cell surface, resulting in the remodeling of heart structure, leading to myocardial interstitial And perivascular fibrosis, ventricular stiffness and affect diastolic function, the clinical symptoms of DCM. The main components of RAS are AngⅡ, Ang- (1-7), Ac-SDKP and angiotensin receptor (ATR) play an important role in the development of diabetic cardiomyopathy. Angiotensin converting enzyme inhibitors angiotensin-converting enzyme inhibitor (ACEI) and angiotensin Ⅱ receptor blocker (angiotensinⅡreceptor bloc-ker, ARB) have some control effect on DCM.