上海交通大学学报(医学版) ›› 2017, Vol. 37 ›› Issue (10): 1441-.doi: 10.3969/j.issn.1674-8115.2017.10.027

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糖尿病性周围神经病变发生机制的研究进展

陆游,陆颖理   

  1. 上海交通大学 医学院附属第九人民医院内分泌代谢科,上海 200011
  • 出版日期:2017-10-28 发布日期:2017-11-01
  • 通讯作者: 陆颖理,电子信箱:luyingli2008@126.com
  • 作者简介:?陆游(1991—),女,博士生;电子信箱:ly012202@163.com
  • 基金资助:
    上海市科学技术委员会科研计划项目(16411971200);上海市浦东新区卫生、计生科技项目(PW2015D-5)

Progress in pathogenesis of diabetic peripheral neuropathy#br#

LU You, LU Ying-li   

  1. Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2017-10-28 Published:2017-11-01
  • Supported by:
     Foundation of Science and Technology Commission of Shanghai Municipality, 16411971200; Health and Family Planning Science and Technology Project of Pudong New Area, Shanghai, PW2015D-5

摘要: 糖尿病性周围神经病变(DPN)是糖尿病常见的并发症之一。DPN 的发病机制尚未明确,是由多因素互相作用的综合结果。 以高糖参与的异常代谢通路为基础,其中包括多元醇通路、己糖胺通路、蛋白激酶 C 通路及糖基化终末产物堆积 。这些代谢通路最 终都会引起细胞内氧化应激反应,诱导免疫反应。另外、脂代谢、生长因子、胰岛素抵抗及神经营养不足等因素直接或间接地参与和 影响了代谢通路。通过对 DPN 发生机制的进一步研究,有利于探索新的治疗方向。文章主要系统阐述 DPN 发生机制,对已知的机制 进行补充和完善。

关键词: 糖尿病性周围神经病变, 糖尿病, 机制

Abstract:

 Diabetic peripheral neuropathy is one of the most common complication of diabetes, which causes pain and inconvenience to the patients and reduces the quality of life. The pathogenesis of DPN is not yet clear, which is the result of multi-factor interaction. Hyperglycemia is clearly an important factor for its pathogenesis and development. Several metabolic pathways have been identified that may relate to the cellular metabolic including glucose flux through the polyol pathway, the hexosamine pathway, production of the protein kinase C isoforms and accumulation of advanced glycation end products. The additive imbalance of these pathways alters the mito-chondrial redox state of the cell and results in oxidative stress. It also causes inflammation. Additionally, growth factors, insulin resistance and lipid abnormality may participate in the metabolic pathway. This review is aimed to elaborate the pathogenesis and complement the known mechanism.

Key words: diabetic peripheral neuropathy, diabetes, pathogenesis