Paulson D J
Department of Physiology, Midwestern University, Downers Grove, IL 60515, USA.
Cardiovasc Res. 1997 Apr;34(1):104-12. doi: 10.1016/s0008-6363(97)00018-7.
Clinical studies have suggested that the diabetic heart is more sensitive to ischemic injury than the non-diabetic heart. However, results from a number of experimental studies using animal models of diabetes reported no change, increased or decreased sensitivity to ischemia. The purpose of this review is to discuss the possible explanations for this apparent discrepancy. Analysis of the conflicting literature on this subject reveals a pattern which suggests that the disparity of experimental findings stems from differences in the duration and severity of the diabetic state, the ischemic flow rate and whether fatty acids are provided as an exogenous substrate. It appears that short-term or mild diabetes is associated with decreased sensitivity to zero-flow ischemic injury. However, as the duration or severity of diabetes increases, this beneficial effect disappears. The diabetic heart also appears to be more vulnerable to injury during low-flow ischemia and when elevated fatty acids are present.
临床研究表明，糖尿病心脏比非糖尿病心脏对缺血性损伤更敏感。然而，一些使用糖尿病动物模型的实验研究结果显示，对缺血的敏感性没有变化、增加或降低。本综述的目的是讨论这种明显差异的可能解释。对关于该主题的相互矛盾的文献进行分析后发现一种模式，这表明实验结果的差异源于糖尿病状态的持续时间和严重程度、缺血流速以及是否提供脂肪酸作为外源性底物的差异。似乎短期或轻度糖尿病与对零流量缺血性损伤的敏感性降低有关。然而，随着糖尿病持续时间或严重程度的增加，这种有益效果消失。糖尿病心脏在低流量缺血期间以及存在升高的脂肪酸时似乎也更容易受到损伤。
