摘要
背景:糖尿病作为一种全身代谢性疾病,不但会引起碳水化合物以及脂肪、蛋白质代谢的紊乱,同时极易发生周围微血管的病变,影响包括椎间盘在内的全身多器官组织的营养代谢过程。目的:综述近年来国内外关于糖尿病对椎间盘退变的影响的研究进展。方法:应用计算机由第一作者在Pub Med数据库和中国知网CNKI数据库,以"intervertebral disc,degeneration,diabetes mellitus"为英文检索词,以"椎间盘,退变,糖尿病"为中文检索词,在1981年1月至2014年1月间共检索到8 414篇相关文献,排除重复研究,共34篇文献符合纳入标准。结果与结论:有关糖尿病慢性并发症的发病机制极为复杂,细胞凋亡是近年来关注的又一热点,研究证明高血糖为椎间盘细胞凋亡的诱导因素之一。糖尿病易引起全身的微小血管病变,因此也极有可能引起椎体终板内血管芽收缩,造成局部血流降低或中断,继而沿终板途径运输的营养物质减少,最终导致椎间盘营养障碍,从而引起椎间盘的退变。椎间盘细胞外基质的减少是椎间盘退变的主要原因。关于糖尿病对椎间盘退变影响的机制尚未清楚,尚需更进一步的研究加以阐述和证实。
BACKGROUND： Diabetes as a systemic metabolic disease induces the disorders of carbohydrates, fat, and protein metabolism, simultaneously easily causes the lesion of surrounding capillaries, and impacts nutrient metabolism of multiple organs including intervertebral discs. OBJECTIVE： To summarize the research progress of diabetes effects on disc degeneration all over the world. METHODS： The first author used the computer to retrieve the information from PubMed and China National Knowledge Infrastructure. The key words were ＂intervertebral disc, degeneration, diabetes meliitus＂ in English and Chinese. 8 414 relevant articles were found, which were published from January 1981 to January 2014. Repetitive studies were excluded and 34 articles were in accordance with the inclusion criteria. RESULTS AND CONCLUSION： Pathogenesis of diabetes complications was very complicated. Apoptosis is a hot focus in recent years. Hyperglycemia has been a inducer for apoptosis in intervertebral discs. Diabetes easily leads to systemic small vessel disease, especially vascular bud contraction in the terminal plate of vertebral body, and results in regional blood flow decrease or interruption. Thus, the nutrient substance carrying along the end plate was reduced, which resulted in disc dystrophy and degeneration. The reduction in extracellular matrix in the intervertebral discs is a major reason for disc degeneration. The mechanisms underlying diabetes effects on disc degeneration remain unclear and deserve further investigations.
出处
《中国组织工程研究》
CAS
北大核心
2015年第33期5378-5382,共5页
Chinese Journal of Tissue Engineering Research
基金
内蒙古自然科学基金项目(2014MS0855)~~
