血脂代谢在糖尿病神经病变中的意义  

Significance of Lipid Metabolism in Diabetic Neuropathy

作　　者：张蕊[1] 刘婷[1] 陈菲 吴粉毅 乔成栋 ZHANG Rui;LIU Ting;CHEN Fei;WU Fenyi;QIAO Chengdong(Department One of Geriatrics The First Clinical Medical College of Lanzhou University,the First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院兰州大学第一医院老年病一科,兰州730000

出　　处：《医学综述》2020年第6期1193-1198,共6页Medical Recapitulate

摘　　要：糖尿病神经病变(DN)是糖尿病的常见并发症,其致病机制尚不完全清楚。血糖控制与DN的改善相关性有限,其不是DN的唯一决定因素,血脂代谢等因素也参与DN的发生、发展。三酰甘油、非酯化脂肪酸、氧化型低密度脂蛋白、氧化型胆固醇、非典型鞘脂、载脂蛋白等可通过不同的作用机制导致DN。严格控制血糖水平、减重、适量运动对DN的治疗至关重要。现已发现贝特类药物、他汀类药物、欧米伽-3、硫辛酸可改善糖尿病患者因血脂代谢紊乱引起的神经损伤。还有一些药物是通过阻断致病通路治疗DN,但这些尚未在临床应用,还需进一步研究。Diabetic neuropathy(DN) is a common complication of diabetes,but its pathogenesis is not fully understood.The correlation of blood glucose control with DN improvement is limited,but it is not the only determinant of DN,that the metabolism of blood lipids is also involved in the occurrence and development of DN.DN can be caused by triglyceride,free fatty acids,oxidized low-density lipoprotein,oxysterols,atypical sphingolipids and apolipoprotein through different mechanisms.Strict control of blood glucose level,weight loss and moderate exercise are essential for the treatment of DN.It has been found that fibrates,statins,omega-3,and lipoic acid can improve the nerve damage caused by dyslipidemia in diabetic patients.Some drugs treatment of DN is by blocking the pathogenesis pathway,but these have not been applied in clinic and need further study.

关 键 词：糖尿病神经病变 血脂紊乱 载脂蛋白 致病机制 干预措施 

分 类 号：R587.2[医药卫生—内分泌]