糖尿病与心力衰竭幻灯PPT学习教案

1、会计学1糖尿病与心力衰竭幻灯糖尿病与心力衰竭幻灯Ramachandran A. Epidemiology of heart disease in type 2 diabetes. Medicographia, 2007,29:207 -212第1页/共31页第2页/共31页Hayat SA, Patel B, Khattar RS, et al. Diabetic cardiomyopathy: mechanisms, diagnosis and treatment. Clinical Science, 2004,107: 539-557 第3页/共31页糖尿病性心肌病糖尿病性心肌病(DCM)

2、第4页/共31页第5页/共31页第6页/共31页第7页/共31页 超氧化物生成超氧化物生成 多元醇旁路多元醇旁路 AGEs生成生成 PKC活化活化 己糖胺旁路己糖胺旁路糖尿病性心肌病变糖尿病性心肌病变糖尿病性心肌微血管病变糖尿病性心肌微血管病变糖尿病性心脏自主神经病变糖尿病性心脏自主神经病变第8页/共31页44%85%。第9页/共31页第10页/共31页第11页/共31页左室舒张末期容积左室舒张末期容积( (前负荷前负荷) )肺肺毛毛细细血血管管楔楔嵌嵌压压正常人正常人糖尿病性心肌病病人糖尿病性心肌病病人任何增加前负荷的因素均可导致急性左心衰竭任何增加前负荷的因素均可导致急性左心衰竭第12页/

3、共31页Levy D, Garrison RJ, Savage DD, et al. N Engl J Med, 1990, 322: 15611566第13页/共31页第14页/共31页第15页/共31页第16页/共31页Opie LH, Schall R. Old antihypertensive and new diabetes. J Hypertens, 2004,22:1453-1458第17页/共31页Woodman RJ, Chew GT, Watts GF. Mechanisms, significance and treatment of vascular dysfuncti

4、on in type 2 diabetes mellitus: focus on lipid-regulating therapy. Drugs, 2005,65:31-74 第18页/共31页第19页/共31页Thallas-Bonke, Lindschau, Rizkalla, et al. Attenuation of extracellular matrix accumulation in diabetic nephropathy by the AGE cross-link breaker ALT-711 via a protein kinase C alpha dependent p

5、athway.J. Diabetes, 2004, 53(11):2921-2930. 第20页/共31页Bril V, Buchanan RA. Long-term effects of ranirestat (AS-3201) on peripheral nerve function in patients with diabetic sensorimotor polyneuropathy. DiabetesCare, 2006, 29(1): 68-72 第21页/共31页第22页/共31页第23页/共31页第24页/共31页Eurich DT. Benefits and harms o

6、f antidiabetic agentsin patients with diabetes and heart failure: systematic review. BMJ.2007,335:497-503第25页/共31页Eurich DT. Benefits and harms of antidiabetic agentsin patients with diabetes and heart failure: systematic review. BMJ.2007,335:497-503 第26页/共31页Dormandy JA, Charbonnel B, Eckland DJ, e

7、t al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study : a randomized controlled trial. Lancet, 2005,366:1279-1289 第27页/共31页Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N En

8、gl J Med, 2007,356: 2457-2471 Krall RL. The record on rosiglitazone and the risk of myocardial infarction. N Engl J Med, 2007,357:28-38 第28页/共31页 von Bibra H, et al. Augmented metabolic control improves myocardial diastolic function and perfusion in patients with non-insulin dependent diabetes. Heart, 2004, 90:1483-1484Malmberg K. Prospective randomized study of intensive insulin treatment