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血管病是糖尿病患者死亡的一个主要原因。糖尿病患者比一般人更容易发生心脏病(多2倍)、坏疽(多5倍)、肾衰(多17倍)及失明(多25倍)。糖尿病的血管硬化发展迅速,具有特殊形式的微血管病。近年来,对其大血管与微血管病变的病理生理机制与治疗的研究有了进展。大血管动脉粥样硬化的发生机制:1.内皮损伤:除高血压外,激素的损害、免疫损伤或代谢改变均可能累及内皮细胞。内皮细胞的通透性增加可使血浆透过视网膜、四肢及肾小球的毛细血管壁。用胰岛素治疗的患者,其胰岛素抗体与胰岛细胞抗涔的出现率增加,可能提示存在免疫损害内皮细胞的机制。2.粘附在损伤内皮上的血小板增加,大概是因为糖尿病患者
Vascular disease is a leading cause of death in diabetic patients. Diabetics are more prone to heart disease (2 times more), gangrene (5 times more), renal failure (17 times more), and blindness (25 times more likely) than most people. Vascular sclerosis develops rapidly and has a special form of microvascular disease. In recent years, its pathophysiology and treatment of macrovascular and microvascular lesions have progressed. The mechanism of macrovascular atherosclerosis: 1. Endothelial injury: In addition to high blood pressure, hormone damage, immune damage or metabolic changes may affect endothelial cells. Increased endothelial permeability allows plasma to penetrate the capillaries of the retina, extremities, and glomeruli. In insulin-treated patients, the increased prevalence of insulin antibodies and pancreatic islet antigens may indicate the existence of a mechanism of immune damage to endothelial cells. 2. Platelets attached to the injured endothelium increase, presumably because of diabetes