检索结果-内蒙古大学图书馆

浙江大学学报（医学版） 2006年第3期35卷 233-237页

作者：李红浙江大学医学院附属第一医院内分泌科浙江杭州310003

糖尿病微血管病变是糖尿病致死致残的主要原因之一,严重影响糖尿病患者的生存质量。其发病机制尚未完全明了,目前认为主要与多元醇通路活跃、氧化应激增加、糖基化终产物形成及蛋白激酶C通路激活有关。以发病机制为靶点的治疗可能会为... 详细信息

糖尿病微血管病变是糖尿病致死致残的主要原因之一,严重影响糖尿病患者的生存质量。其发病机制尚未完全明了,目前认为主要与多元醇通路活跃、氧化应激增加、糖基化终产物形成及蛋白激酶C通路激活有关。以发病机制为靶点的治疗可能会为预防和延缓糖尿病微血管病变的发生发展带来新的希望。

关键词：糖尿病/并发症糖尿病血管病变/病因学糖尿病血管病变/病理生理学糖尿病血管病变/药物疗法

来源：评论

学校读者我要写书评

暂无评论

Molecular basis for a link between complement and the vascular complications of diabetes

引用

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 2000年第10期97卷 5450-5455页

作者： Acosta, J Hettinga, J Flückiger, R Krumrei, N Goldfine, A Angarita, L Halperin, J Harvard Univ Sch Med Lab Membrane Transport Boston MA 02115 USA Brigham & Womens Hosp Dept Med Boston MA 02115 USA Joslin Diabet Ctr Boston MA 02115 USA

Activated terminal complement proteins C5b to C9 form the membrane attack complex (MAC) pore. Insertion of the MAC into endothelial cell membranes causes the release of growth factors that stimulate tissue growth and proliferation. The complement regulatory membrane protein CD59 restricts MAC formation. Because increased cell proliferation characterizes the major chronic vascular complications of human diabetes and because increased glucose levels in diabetes cause protein glycation and impairment of protein function, we investigated whether glycation could inhibit CD59. Glycation-inactivation of CD59 would cause increased MAC deposition and MAC-stimulated cell proliferation. Here, we report that (i) human CD59 is glycated in vivo, (ii) glycated human CD59 loses its MAC-inhibitory function, and (iii) inactivation of CD59 increases MAC-induced growth factor release from endothelial cells. We demonstrate by site-directed mutagenesis that residues K41 and H44 form a preferential glycation motif in human CD59. The presence of this glycation motif in human CD59, but not in CD59 of other species, may help explain the distinct propensity of humans to develop vascular proliferative complications of diabetes.

关键词：氨基酸序列 CHO细胞细胞培养的克隆分子补体膜攻击复合物/生理学仓鼠亚科糖尿病血管病变/遗传学糖尿病血管病变/病理生理学内皮血管/细胞学内皮血管/生理学红细胞/生理学葡萄糖/药理学糖基化 K562细胞核糖/药理学序列比对转染脐静脉动物豚鼠人类小鼠大鼠

来源：评论

学校读者我要写书评

暂无评论

Improvement in endothelial function by angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus

引用

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第6期33卷 1506-1511页

作者： O'Driscoll, G Green, D Maiorana, A Stanton, K Colreavy, F Taylor, R Univ Western Australia Dept Human Movement Nedlands WA 6907 Australia Univ Western Australia Dept Med Nedlands WA 6009 Australia Royal Perth Hosp Dept Cardiol Endocrinol Nedlands WA Australia Royal Perth Hosp Dept Diabet Nedlands WA Australia

OBJECTIVES The aim of this study was to assess the effect. of angiotensin-converting enzyme (ACE) inhibition with enalapril on forearm endothelial function in subjects with type II diabetes. BACKGROUND Endothelial function is depressed in the presence of conventional risk factors for atherosclerosis, and various therapies, such as lipid-lowering therapy in hypercholesterolemia, can improve endothelial-mediated vasodilatian. ACE inhibition has improved such function in several conditions including type I diabetes, but there is no evidence for a beneficial effect in type II diabetes. METHODS The influence of enalapril (10 mg twice daily for 4 weeks) on endothelium-dependent and -independent vasodilator function was determined in 10 type ii diabetic subjects using a. double-blinded placebo-controlled crossover protocol. Forearm blood flow was measured using strain-gage plethysmography and graded intrabrachial infusion of acetylcholine (ACh), N-G-monomethyl-L-arginine (LNMMA) and sodium nitroprusside (SNP). RESULTS Enalapril increased the response to the endothelium-dependent vasodilator, ACh (p < 0.02) and the vasoconstrictor response to the nitric oxide (NO) synthase inhibitor, LNMMA (p < 0.002). No difference was evident in the response to SNP. CONCLUSIONS In type II diabetic subjects without evidence of vascular disease, the ACE inhibitor enalapril improved stimulated and basal NO-dependent endothelial function. The study extends the Spectrum of beneficial effects demonstrated to result from ACE inhibition in diabetes. (C) 1999 by the American College of Cardiology.

关键词：乙酰胆碱血管紧张素转换酶抑制药/投药和剂量血管紧张素转换酶抑制药/副作用血流速度/药物作用血流速度/生理学糖尿病 2型/药物疗法糖尿病 2型/病理生理学糖尿病血管病变/药物疗法糖尿病血管病变/病理生理学剂量效应关系药物双盲法用药计划表依那普利/投药和剂量依那普利/副作用内皮血管/药物作用内皮血管/病理生理学前臂/血液供给硝普钠 ωN-甲基精氨酸老年人人类中年人

来源：评论

学校读者我要写书评

暂无评论

Coronary artery distensibility in diabetic patients with simultaneous measurements of luminal area and intracoronary pressure - Evidence of impaired reactivity to nitroglycerin

引用

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第4期34卷 1075-1081页

作者： Vavuranakis, M Stefanadis, C Triandaphyllidi, E Toutouzas, K Toutouzas, P Univ Athens Hipprokrat Hosp Dept Cardiol Athens Greece

OBJECTIVE This study investigated whether noninsulin dependent diabetes mellitus (NIDDM) adversely affects the elastic properties of the coronary arteries in patients with coronary artery disease (CAD) and NIDDM. BACKGROUND Attenuated vascular smooth muscle dilation to exogenous donors of nitric oxide, such as nitroglycerin, has been observed with forearm blood flow studies in patients with NIDDM. METHODS Twenty patients with CAD and NIDDM (diabetics), and 20 patients with only CAD (nondiabetics) were evaluated. Intracoronary ultrasound (ICUS) imaging with simultaneous intracoronary pressure (P-2) recordings were performed at the imaging site with 0.014 in fiber-optic high fidelity pressure monitoring wire. The same wire was used as guide wire for the ICUS catheter. Sites with less than 50% luminal stenosis by ICUS were studied. Recordings were done before and after 300 mu g of intracoronary nitroglycerin (IC-NTG). Electrocardiographic tracings recorded simultaneously with ICUS images were used for timing. Systolic and diastolic cross-sectional lumen area (CSLA) and coronary artery distensibility (C-DIST) were measured, C-DIST = {(systolic CSLA-diastolic CSLA)/[(intracoronary pulse pressure) x (diastolic CSLA)]} x 1,000. RESULTS Diabetics had smaller CSLA (diabetics = 8.6 +/- 0.6 mm(2), nondiabetics = 11.5 +/- 0.5 mm(2), p < 0.01). Although C-DIST was similar before IC-NTG in the two groups, it became significantly lower in diabetics after IC-NTG (diabetics C-DIST = 3.02 +/- 0.14 mm Hg-1 nondiabetics C-DIST = 4.21 +/- 0.15 mm Hg-1, p < 0.01). Degrees of circumference involved, total plaque burden and composition were similar in both groups. CONCLUSIONS Noninsulin dependent diabetes mellitus reduces C-DIST after IC-NTG administration. (J Am Coll Cardiol 1999;34:1 075-81) (C) 1999 by the American College of Cardiology.

关键词：血压/生理学冠心病/诊断显像冠心病/病理生理学冠状血管/生理学糖尿病 2型/诊断显像糖尿病 2型/病理生理学糖尿病血管病变/诊断显像糖尿病血管病变/病理生理学心舒期/生理学弹性心电描记术腔内超声检查/仪器和设备一氧化氮/生理学硝酸甘油观察者偏差心缩期/生理学血管舒张/生理学血管舒张药成年人老年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Epidural spinal cord electrical stimulation in diabetic critical lower limb ischemia

引用

JOURNAL OF DIABETES AND ITS COMPLICATIONS 1999年第5-6期13卷 293-299页

作者： Petrakis, IE Sciacca, V Univ Roma La Sapienza Policlin Umberto I Dept Gen Surg 1 Rome Italy

Spinal cord stimulation (SCS) has been suggested to improve microcirculatory blood flow to relieve ischemic pain and to reduce amputation rate in patients with peripheral arterial occlusive disease (PAOD). The aim of this study was to evaluate the specific prognostic parameters in the prediction of successful SCS, in diabetic patients, performing a retrospective data analysis. To perform this evaluation, 64 diabetic patients (39 men, 25 women;mean age, 69 years) classified as Fontaine's stage III and IV, with PAOD, were treated with SCS for rest pain and trophic lesions with dry gangrene, after failed conservative or surgical treatment. In clinical controls, pedal transcutaneous oxygen tension (TcPO2), ankle/brachial blood pressure index (ABI), and toe pressure Doppler measurements were utilized to select and followup the patients. After 58 months of follow-up (range, 20-128 months), pain relief greater than 75% and limb salvage were achieved in 38 diabetic patients. A partial success was obtained in nine patients with pain relief greater than 50% and limb salvage for at least 6 months. The method failed in 17 patients or the device was removed due to technical problems, and the limb was amputated in these patients. TcPO2 was assessed on the dorsum of the foot. Clinical improvement and SCS success were associated with increase of TcPO2, before and after implantation. Limb salvage was achieved in the patients who had significant TcPO2 increase within the 2 weeks of the testing period, independently of the stage of the disease. A TcPO2 increase of more than 50% in the first 2 months after implantation was predictive of success, and was related to the presence of adequate paresthesias in the painful area during the trial period. TcPO2 significantly increased after long-term follow-up in all patients with limb salvage from 22.1 to 43.1 mm Hg in the rest pain patients, from 15.8 to 36.4 mm Hg in those with trophic lesions of less than 3 cm(2), and from 12.1 to 28.1 in th

关键词：糖尿病血管病变/病理生理学糖尿病血管病变/治疗电刺激疗法/方法随访研究缺血/病理生理学缺血/治疗腿/血液供给微循环/病理生理学疼痛局部血流脊髓时间因素治疗结果老年人老年人 80以上女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Impaired microvascular responses to acute hyperglycemia in type I diabetic rats

引用

JOURNAL OF DIABETES AND ITS COMPLICATIONS 1999年第1期13卷 39-44页

作者： Renaudin, C Michoud, E Lagarde, M Wiernsperger, N Inst Natl Sci Appl Lipha INSERM U352 Diabet Microangiopathy Res Unit F-69621 Villeurbanne France

Abnormal reactivity of resistance vasculature may induce long-term alterations in regional hemodynamics, contributing to the pathogenesis of diabetic microangiopathy. The purpose of this study was to examine the responses of microvessels to a hyperglycemic episode aimed at mimicking a physiological stimulus such as the postprandial state. This study is the first to report the direct, in situ, visualization of this situation by intravital microscopy in the skeletal muscle of diabetic rat and is particularly interesting as-it applies to an iterative, physiological stimulus. The study was conducted in 5-month-old rats, either nondiabetic (ND) or rendered diabetic (D) for 12 weeks (streptozotocin, 60 mg/kg, i.v.). Intravital microscopy was used to examine diameter and vasomotion changes in precapillary arterioles (< 20 mu m) in the spinotrapezius muscle of fasted, anesthetized rats, before and up to 60 min after infusion of glucose or isotonic saline. After intravenous glucose infusion, a precapillary arteriolar vasoconstriction associated with an increase in the number of arterioles presenting vasomotion were seen in ND rats. In contrast, no modification in either parameter was observed in D rats. Our results indicate that, microvessels react to acute changes in the metabolic environment such as induced by elevation of plasma glucose. There was a complete loss of reactivity (vasoconstriction and vasomotion) of precapillary arterioles to superimposed hyperglycemia in D rats. According to the "hemodynamic hypothesis", this impaired vasoconstriction could result in hyperperfusion of microvessels and subsequent microvascular damages which might contribute to the development of diabetic microangiopathy. (C) 1999 Elsevier Science Inc.

关键词：小动脉/病理生理学糖尿病实验性/血液糖尿病实验性/病理生理学糖尿病 1型/血液糖尿病 1型/病理生理学糖尿病血管病变/病理生理学高血糖症/病因学高血糖症/病理生理学微循环/病理生理学模型心血管肌骨骼/血液供给大鼠 Wistar 血管收缩动物男(雄)性大鼠

来源：评论

学校读者我要写书评

暂无评论

Differential effects of antihypertensive agents on electrocardiographic voltage: Results from the Appropriate Blood Pressure Control in Diabetes (ABCD) trial

引用

AMERICAN HEART JOURNAL 2003年第6期145卷 993-998页

作者： Havranek, EP Esler, A Estacio, RO Mehler, PS Schrier, RW Univ Colorado Hlth Sci Ctr Div Cardiol Denver CO 80262 USA Univ Colorado Hlth Sci Ctr Div Gen Internal Med Denver CO 80262 USA Univ Colorado Hlth Sci Ctr Div Renal Dis & Hypertens Denver CO 80262 USA Dept Med Denver CO USA Colorado Prevent Ctr Denver CO USA Denver Hlth & Hosp Denver CO USA

Background Serial decline in electrocardiographic voltage in patients with increased left ventricular mass has been associated with a lower risk of cardiovascular events. Methods We studied 468 patients with diabetes mellitus and hypertension in the Appropriate Blood Pressure Control in Diabetes (ABCD) trial. Patients were randomized in a stratified design to receive initial treatment with either enalapril or nisoldipine and to either intensive or moderate treatment goals. We measured an electrocardiographic index for increased left ventricular mass, the adjusted Cornell voltage, serially by treatment group. The association between changes in electrocardiographic voltage and cardiovascular events was defined with Cox proportional hazards analysis. Results In 5 years of follow-up, the decline in adjusted Cornell voltage was significantly greater for patients treated with enalapril than for patients treated with nisoldipine (repeated measures analysis of variance P = .002). In the Cox proportional hazards model, treatment assignment (enalapril vs nisoldipine) was the strongest predictor of cardiovascular events, but the presence of coronary disease at baseline, the duration of diabetes mellitus, and change in voltage were also independent predictors of cardiovascular events. Conclusions In the ABCD study, enalapril treatment was associated with a lower risk of myocardial infarction. The reduction in left ventricular mass as reflected by diminished electrocardiographic voltage may explain some, but not all,. of the effect of enalapril in this study.

关键词：抗高血压药/治疗应用血压/药物作用血压/生理学钙通道阻滞药糖尿病 2型/并发症糖尿病 2型/病理生理学糖尿病血管病变/药物疗法糖尿病血管病变/病理生理学双盲法心电描记术依那普利/治疗应用高血压/药物疗法高血压/病理生理学肥大左心室/药物疗法肥大左心室/病理生理学尼索地平/治疗应用比例危险度模型前瞻性研究成年人老年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Vascular endothelial growth factor and diabetic nephropathy

引用

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS 1999年第5期22卷 297-299页

作者： Gudehithlu, KF Singh, AK Cook Cty Hosp Hektoen Inst Med Res Div Nephrol Chicago IL 60612 USA

来源：评论

学校读者我要写书评

暂无评论

The relationship of prorenin values to microvascular complications in patients with insulin-dependent diabetes mellitus

引用

JOURNAL OF DIABETES AND ITS COMPLICATIONS 1999年第1期13卷 45-51页

作者： Davies, L Fulcher, GR Atkins, A Frumar, K Monaghan, J Stokes, G Clifton-Bligh, P McElduff, A Robinson, B Stiel, J Twigg, S Wilmshurst, E Royal N Shore Hosp Dept Endocrinol St Leonards NSW 2065 Australia

We have performed a cross-sectional analysis of the relationship between prorenin values and the microvascular complications of diabetes in a well controlled population of insulin-dependent diabetes mellitus (IDDM) subjects. One hundred and thirty-nine subjects (75 men, 64 women, age 44 +/- 17 years;duration of diabetes 19 +/- 15 years), formed the study group. Sixty-seven subjects (48.2%) had no complications, 55 (39.6%) had retinopathy alone, and 17 (12.2%) had retinopathy and albuminuria. Patients with no complications had lower prorenin values than those with microvascular complications (p < 0.001), whilst patients with both albuminuria and retinopathy had higher values than those with retinopathy alone (p < 0.05), Retinopathy was associated with duration of diabetes (p < 0.0001), diastolic blood pressure (p < 0.02) and albuminuria (p < 0.0001) while albuminuria was associated with prorenin (p < 0.02), serum triglyceride (p < 0.01) and retinopathy (p <: 0.001). Patients with albuminuria were 5.5 times more likely to have raised prorenin values (>80 ng/ml/h) than those with normal albumin excretion [95% confidence interval (CI): 1.48-20.12] and those with retinopathy alone were 2.5 times as likely (95% CI: 1.19-5.15). Eighty patients with IDDM (40 males, 40 females;age: 47 +/- 17 years;duration of diabetes: 20 +/- 15 years), had retinal photography performed to determine the association between the severity of retinopathy and prorenin values. Retinopathy was more severe in patients with retinopathy and albuminuria than in those with retinopathy alone (p < 0.002). When the prorenin values of patients with more marked retinopathy (eye grade greater than 3) were compared, prorenin values of those with retinopathy and albuminuria were greater than those of patients with retinopathy alone [269 (139-1406) versus 91 (41-273) ng/mL/h: geometric mean (range);p < 0.05]. Furthermore, when patients without albuminuria were considered, there was no significant difference betw

关键词：白蛋白尿/血液白蛋白尿/病理生理学生物学标记/血液血压胆固醇/血液胆固醇 HDL/血液横断面研究糖尿病 1型/血液糖尿病 1型/病理生理学糖尿病血管病变/血液糖尿病血管病变/病理生理学糖尿病肾病/血液糖尿病肾病/病理生理学糖尿病视网膜病变/血液糖尿病视网膜病变/病理生理学酶前体/血液眼底摄影术肾素/血液甘油三酯类/血液成年人女(雌)性人类男(雄)性

来源：评论

学校读者我要写书评

暂无评论

Reversed circadian blood pressure rhythm independently predicts endstage renal failure in non-insulin-dependent diabetes mellitus subjects

引用

JOURNAL OF DIABETES AND ITS COMPLICATIONS 1999年第4期13卷 224-231页

作者： Nakano, S Ogihara, M Tamura, C Kitazawa, M Nishizawa, M Kigoshi, T Uchida, K Kanazawa Med Univ Dept Internal Med Div Endocrinol Uchinada Ishikawa 9200293 Japan

To investigate the significance of reversed circadian blood pressure (BP) rhythm as a predictor for diabetic endstage renal failure, introduction of hemodialysis (HD) was determined as an end point in 325 non-insulin-dependent diabetes mellitus (NIDDM) subjects, in whom 24-h BPs had been monitored during their first admissions between 1988 and 1996. Circadian BP rhythm was analyzed by the COSINOR method, as previously reported. After exclusion of 68 dropout subjects, 257 were recruited for further analyses, in which 194 had normal circadian BP rhythms (N), and the remaining 63 had reversed rhythms (R). During this follow-up period, the numbers of HD-introduced subjects in N and R were 6 and 16, respectively, showing a higher prevalence in the latter (p < 0.001, chi(2) test). Follow-up periods were significantly shorter in HD-introduced diabetic subjects of N and R than those in HD-free subjects of each group. In baseline characteristics, there were no differences in age, gender, or serum creatinine between HD-free and HD-introduced subjects of N or R. With regard to microvascular complications, the degree of retinopathy and nephropathy in N and R tended to be more pronounced in H-introduced subjects than in H-free subjects. Further, mean levels of circadian mean BP rhythms in H-introduced subjects of N or R were similarly high, compared with those in H-free subjects of each group, irrespective of circadian BP pattern. Unadjusted H-free times were estimated by the Kaplan-Meier method, with a significant difference noted between N and R (p < 0.001;log-rank test). The Cox proportional-hazards model adjusted for circadian BP pattern, age, gender, blood pressure level, glycemic control, duration of diabetes, serum total protein, and serum creatinine demonstrated that circadian BP pattern, age, gender (female), blood pressure level (hypertension), and serum creatinine exhibited significant high relative risks. Thus, our data suggest that reversed circadian BP rhythm is an

关键词：血糖/代谢血压血蛋白质类/分析昼夜节律肌酸酐/血液糖尿病 2型/并发症糖尿病血管病变/病理生理学肾功能衰竭慢性/病因学肾功能衰竭慢性/病理生理学肾功能衰竭慢性/治疗肾透析成年人老年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：