Carter A M, Grant P J
Unit of Molecular Vascular Medicine, Research School of Medicine, University of Leeds, Leeds General Infirmary, UK.
Diabet Med. 1997 Jun;14(6):423-32. doi: 10.1002/(SICI)1096-9136(199706)14:6<423::AID-DIA421>3.0.CO;2-F.
Diabetes mellitus is characterized by fasting hyperglycaemia and the development of chronic vascular complications. While microvascular disease has been strongly related to glycaemic control, the major cause of mortality in diabetes is due to macrovascular disease affecting the cardiac and cerebrovascular circulations, which appear to have a more complex pathogenesis. Diabetes is associated with a 3-5-fold increase in death from myocardial infarction and similar figures pertain to stroke. The processes involved in atherothrombotic disease are complex and include variation in lipid metabolism, vascular responses, cell/cell interactions, and in the fluid and cellular phases of coagulation and fibrinolysis. The complex interactions between all of these processes are crucially altered by the metabolic milieu that characterizes diabetes mellitus, tipping the delicate balance towards atheroma formation, platelet aggregation and thrombus formation. This article will review these mechanisms and the effects of diabetes in the pathogenesis of vascular disease.
糖尿病的特征是空腹血糖升高以及慢性血管并发症的发生。虽然微血管疾病与血糖控制密切相关，但糖尿病患者的主要死亡原因是影响心脏和脑血管循环的大血管疾病，其发病机制似乎更为复杂。糖尿病使心肌梗死死亡风险增加3至5倍，中风的情况也类似。动脉粥样硬化血栓形成疾病涉及的过程很复杂，包括脂质代谢、血管反应、细胞/细胞相互作用以及凝血和纤溶的液体和细胞阶段的变化。糖尿病特有的代谢环境会严重改变所有这些过程之间的复杂相互作用，使微妙的平衡倾向于动脉粥样硬化形成、血小板聚集和血栓形成。本文将综述这些机制以及糖尿病在血管疾病发病机制中的作用。
