摘要
糖尿病周围神经病变(DPN)是严重影响患者生活质量的糖尿病常见并发症。本文综述了DPN的流行病学、发病机制、诊断分型及治疗策略的研究进展。研究表明,DPN除经典的发病机制外,与细胞Na^(+)-K^(+)-ATP酶表达下调、线粒体功能障碍、DNA损伤及炎症因子水平升高有关,还与肠道菌群失调、氨基酸代谢紊乱及施万细胞(SC)功能障碍等相关。皮肤内膜神经纤维密度测量和新兴高分辨率神经成像技术可作为新型的诊断工具。一些新型降糖药物显示了神经保护作用,美洛加巴林、克利加巴林等第3代新型钙离子通道调节剂在糖尿病周围神经病变性疼痛疗效与安全性方面展现了良好前景。未来可通过早期诊断、精准治疗、新型药物的研发进一步改善患者预后。
Diabetic peripheral neuropathy(DPN)is a prevalent complication that seriously impairs the quality of patients'life.This article reviews the latest research progress in the epidemiology,pathogenesis,diagnostic classification and treatment strategies of DPN.Studies have shown that DPN is associated with the downregulation of Na^(+)-K^(+)-ATPase expression,mitochondrial dysfunction,DNA damage,and elevated inflammatory cytokines in DPN pathogenesis in addition to classic pathogenesis,additional contributors include gut microbiota dysbiosis,amino acid metabolism dysregulation,and Schwann cell(SC)dysfunction.Intraepidermal nerve fiber density and emerging high-resolution neuroimaging techniques can be used as new diagnostic tools.Some new antidiabetic drugs have shown neuroprotective effects,and the third generation of new calcium channel modulators such as Mirogabalin and Cilgabalin show a good prospect in the efficacy and safety of diabetic peripheral neuropathic pain(DPNP).In the future,the prognosis of patients can be further improved through early diagnosis,precise treatment and the development of new drugs.
作者
杜瑞琴
李全民
DU Ruiqin;LI Quanmin(Department of Endocrinology and Rheumatology-immunology,Specialty Medical Center of the Rocket Force,Beijing 100088,China)
出处
《临床药物治疗杂志》
2025年第7期10-14,共5页
Clinical Medication Journal
