糖尿病足肌腱坏死隐性病变机制研究  

Mechanism study on latent pathological changes of tendon in diabetic foot gangrene

作　　者：张磊[1,2] 刘立昌[2] 王义成[3] 曹烨民[3] 奚九一[3] 

机构地区：[1]上海中医药大学附属曙光医院,201203 [2]深圳市第二人民医院 [3]上海市中西医结合医院

出　　处：《中国糖尿病杂志》2010年第7期515-518,共4页Chinese Journal of Diabetes

摘　　要：目的探讨糖尿病足筋疽(肌腱坏死症)肌腱"隐性病变"的发病机制。方法腹腔一次性注射链脲佐菌素(STZ)复制Wistar大鼠糖尿病模型,动态观察成模大鼠体重、血糖;定期处死大鼠,检测后爪部肌腱组织病理、超微结构及组织糖、糖基化终产物(AGEs)、羟脯氨酸(Hyp)、髓过氧化物酶(MPO)变化。结果模型各组肌腱组织病理及超微结构、组织糖、AGEs、Hyp、MPO均有不同程度的改变。随着时间延长,肌腱组织病理及超微结构组织损害程度持续加重;组织糖、AGEs、MPO呈逐渐上升趋势,而Hyp呈逐渐下降趋势,与正常组比较,有统计学差异(P<0.05～P<0.01)。结论糖尿病模型大鼠后肢肌腱组织早期即出现隐性病理损害;其机制可能与肌腱组织糖含量升高、蛋白非酶糖化、肌腱基质病理改变和炎症反应等有关。Objective To investigate the mechanism of latent pathological changes of tendon in diabetic foot gangrene （syndrome of tendon degeneration and necrosis）. Methods Diabetic rat model were established by STZ injection. The changes of rat body weight, fasting blood glucose were observed dynamically. The pathological changes, ultra structure, glucose, AGEs, hydroxyproline （Hyp）, and myeloperoxidase（MPO） in tendon tissues were detected after rats were killed. Results The pathology and uhra structure,glucose, AGEs, Hyp, MPO in tendon tissues of all diabetic groups were changed in various degree. With the time prolonged, the tendon pathology and ultra-structure revealed an aggravated injury. As compare with the normal group,the levels of glucose, AGEs and MPO in tendon tissues had an upward tendency, while MPO level had a downward tendency（all P〈0.05 or P〈0.01）. Conclusions The latent pathological changes in tendon tissues in lower limbs of diabetic rats occur in early stage. Its mechanism may be related with high glucose level, protein non enzyme glycosylation, matrix pathological changes and inflammation reaction in tendon tissue.

关 键 词：糖尿病足 糖尿病筋疽 肌腱变性坏死症 发病机制 

分 类 号：R587.2[医药卫生—内分泌]