在心肺旁路术后微血管反应的变化,在控制不良或控制的糖尿病患者中
Jun Feng1, Yuhong Liu, Louis M Chu
1Division of Cardiothoracic Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
Circulation
|September 12, 2012
概括
控制不良的糖尿病会在心脏手术期间损害血管功能. 心肺绕道进一步降低反应能力,特别是在糖尿病患者中,与增加的蛋白激酶C和氧化应激有关.
科学领域:
- 心血管科学 心血管科学
- 糖尿病学 糖尿病学
- 手术研究的研究.
背景情况:
- 在接受冠状动脉旁路移植 (CABG) 的糖尿病患者中,研究了心肺旁路 (CPB) 对外周动脉反应性的影响.
- 比较控制不良的糖尿病患者 (UDM),控制的糖尿病患者 (CDM) 和非糖尿病患者 (ND).
研究的目的:
- 评估CPB在不同血糖控制状态下对动脉功能和信号通路的影响.
- 确定心脏手术期间糖尿病患者血管反应受损的潜在机制.
主要方法:
- 在CPB之前和之后从UDM,CDM和ND患者中采集了骨肌动脉.
- 在试验室评估了对血管扩展剂 (ADP,物质P,SNP) 的放松反应.
- 测量了蛋白质激酶C (PKC) -α,PKC-β,蛋白质氧化和尼铁的表达.
主要成果:
- 与CDM和ND组相比,UDM患者的动脉放松反应在基线下降.
- 在所有组中,CPB显著降低了放松反应,在UDM患者中降低更为明显.
- UDM组显示,CPB后SNP反应减少增加,PKC-α,PKC-β,蛋白质氧化和尼铁水平升高.
结论:
- 控制不良的糖尿病在CPB前后都会显著损害动脉功能.
- 增加的PKC-α,PKC-β表达/激活,以及增强的氧化/化应激有助于这些血管变化.
- 研究结果强调了血糖控制不良在心脏手术期间对血管健康的有害影响.
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