糖尿病急性心肌梗死后易发心力衰竭的机制

在糖尿病的患者,如果不合并冠心病心肌缺血,基本均处于亚临床状态的心肌损害,心功能表现为早期舒张功能不全以及晚期合并收缩功能不全,其机制是心肌能量代谢的异常导致一系列的病理生理学改变,包括糖类代谢紊乱、脂肪酸的氧化和心肌脂质聚集等,也就是目前常说的糖尿病心肌病。对于严重的糖尿病患者如果遭遇心肌缺血的打击,其更加容易发生心力衰竭和死亡,拥有明显更差的预后,其机制是什么呢？现将详细加以阐述。

Mechanism of Heart Failure After Acute Myocardial Infarction in Diabetic Patients

In diabetic patients, it, the absence of myocardial injury or coronary heart disease （CHD） , the disease is ahnost subclini- cal and manifests primarily as diastolic dysfunction and abnormal energy substrate metabolism （increased myocardial fatty acid oxidation, lip- id accumulation, and impaired carbohydrate metabolism）. However, cardiac function may be more likely to fail when a compromised diabetic patient is subjected to cardiac isehemia, and diabetic patients with heart failure （HF） have a poorer prognosis compared with non-diabetic ones. The mecilanisms are described in this article.