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糖尿病性心肌病——从基础到诊断再到治疗

Diabetic Cardiomyopathy-From Basics through Diagnosis to Treatment.

作者信息

Radzioch Ewa, Dąbek Bartłomiej, Balcerczyk-Lis Marta, Frąk Weronika, Fularski Piotr, Młynarska Ewelina, Rysz Jacek, Franczyk Beata

机构信息

Department of Nephrocardiology, Medical Univeristy of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland.

Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland.

出版信息

Biomedicines. 2024 Mar 29;12(4):765. doi: 10.3390/biomedicines12040765.

Abstract

Diabetic cardiomyopathy (DCM) is the development of myocardial dysfunction in patients with diabetes despite the absence of comorbidities such as hypertension, atherosclerosis or valvular defect. The cardiovascular complications of poorly controlled diabetes are very well illustrated by the U.K. Prospective Diabetes Study (UKPDS), which showed a clear association between increasing levels of glycated hemoglobin and the development of heart failure (HF). The incidence of HF in patients with diabetes is projected to increase significantly, which is why its proper diagnosis and treatment is so important. Providing appropriate therapy focusing on antidiabetic and hypolipemic treatment with the consideration of pharmacotherapy for heart failure reduces the risk of CMD and reduces the incidence of cardiovascular complications. Health-promoting changes made by patients such as a low-carbohydrate diet, regular exercise and weight reduction also appear to be important in achieving appropriate outcomes. New hope for the development of therapies for DCM is offered by novel methods using stem cells and miRNA, which, however, require more thorough research to confirm their efficacy.

摘要

糖尿病性心肌病(DCM)是指糖尿病患者在不存在高血压、动脉粥样硬化或瓣膜缺陷等合并症的情况下发生的心肌功能障碍。英国前瞻性糖尿病研究(UKPDS)很好地说明了控制不佳的糖尿病的心血管并发症,该研究表明糖化血红蛋白水平升高与心力衰竭(HF)的发生之间存在明显关联。预计糖尿病患者中HF的发病率将显著增加,这就是其正确诊断和治疗如此重要的原因。提供以抗糖尿病和降血脂治疗为重点并考虑心力衰竭药物治疗的适当疗法可降低CMD风险并减少心血管并发症的发生率。患者做出的促进健康的改变,如低碳水化合物饮食、定期锻炼和减肥,在实现适当结果方面似乎也很重要。使用干细胞和miRNA的新方法为DCM治疗的发展带来了新希望,然而,这需要更深入的研究来证实其疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/138e/11048005/038208275d9d/biomedicines-12-00765-g001.jpg

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