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血管内皮是一个十分活跃的内分泌器官,通过其分泌的多种生物活性物质如一氧化氮、前列环素、内皮素、血管紧张素Ⅱ、纤溶酶原激活物抑制物-1等而发挥屏障功能、调节血管通透性、保持血管张力和血流通畅以及调节血管平滑肌细胞生长增殖等重要功能。近年来的观点认为,2型糖尿病长期慢性的血管内皮低度炎症将导致大血管并发症如动脉粥样硬化。本文重点从脂毒性、糖毒性、高血压、胰岛素抵抗四方面分别阐述了2型糖尿病发生内皮功能障碍的机制,并且二者互为恶性循环。通过检测上述内皮源性因子含量或活性以及应用高频超声检测外周血管的血流介导的血管舒张反应性来评价发生内皮功能障碍的程度,并提出在2型糖尿病中针对内皮功能障碍的防治措施。
The vascular endothelium is a very active endocrine organ that exerts its barrier function through the secretion of a variety of bioactive substances such as nitric oxide, prostacyclin, endothelin, angiotensin II, plasminogen activator inhibitor-1 and the like , Regulate vascular permeability, maintain vascular tone and blood flow and regulation of vascular smooth muscle cell proliferation and other important functions. In recent years, it has been suggested that long-term chronic low endovascular inflammation of type 2 diabetes will lead to macrovascular complications such as atherosclerosis. This article focuses on the mechanism of endothelial dysfunction in type 2 diabetes mellitus from the aspects of lipid toxicity, sugar toxicity, hypertension and insulin resistance, and the two are mutually vicious cycles. The level of endothelial dysfunction was evaluated by examining the above-mentioned content or activity of endothelium-derived factor and using high-frequency ultrasonography to detect peripheral blood flow-mediated vasodilation responsiveness and proposing prevention and treatment of endothelial dysfunction in type 2 diabetes Measures.