Feng Jun, Sellke Frank
Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Rhode Island Hospital, Rhode Island, USA *Both the authors contributed equally to the writing of this article.
Curr Opin Cardiol. 2016 Nov;31(6):618-624. doi: 10.1097/HCO.0000000000000340.
The purpose of the current review is to describe the changes of microvascular function in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass (CPB) and cardiac surgery.
Cardiac surgery, especially that involving cardioplegia and CPB, is associated with significant changes in vascular reactivity of coronary/peripheral microcirculation, vascular permeability, gene/protein expression, and programmed cell death, as well as with increased morbidity and mortality after surgical procedures. In particular, these changes are more profound in patients with poorly controlled diabetes.
Because alterations in vasomotor regulation are critical aspects of mortality and morbidity of cardioplegia/CPB, a better understanding of diabetic regulation of microvascular function may lead to improved postoperative outcomes of patients with diabetes after cardioplegia/CPB and cardiac surgery.
本综述的目的是描述糖尿病患者在心脏停搏、体外循环（CPB）及心脏手术后微血管功能的变化。
心脏手术，尤其是涉及心脏停搏和CPB的手术，与冠状动脉/外周微循环的血管反应性、血管通透性、基因/蛋白质表达及程序性细胞死亡的显著变化相关，也与手术后发病率和死亡率增加有关。特别是，这些变化在糖尿病控制不佳的患者中更为明显。
由于血管舒缩调节的改变是心脏停搏/CPB死亡率和发病率的关键因素，更好地了解糖尿病患者微血管功能的调节可能会改善糖尿病患者在心脏停搏/CPB及心脏手术后的术后结局。
