2型糖尿病与心力衰竭（Type 2 diabetes and heart failure）.doc

2型糖尿病与心力衰竭（Type 2 diabetes and heart failure） Type 2 diabetes mellitus and heart failure Diabetes mellitus (DM) is an important risk factor for atherosclerosis, but it is not yet fully understood that DM is an important independent risk factor for heart failure (HF). The Framingham study found that the incidence of HF in patients with DM was 4 times higher than in men without DM and 8 times higher in women. DM can lead to 1 steps to worsen the prognosis of HF and significantly increase the admission rate and mortality of HF patients. Coexistence of the 2, prognosis is very poor. This article focuses on the mechanism of HF and the progress of drug therapy in DM. 1 pathogenesis of diabetic cardiac insufficiency The mechanism of DM complicated with cardiac insufficiency is 10 complex, which may be related to diabetic heart damage except coronary heart disease, myocardial ischemia and hypertension, left ventricular strain. Including: the diabetic cardiomyopathy; the diabetic microangiopathy, the occurrence of microcirculation; diabetic autonomic neuropathy, heart neurogenic regulation disorder; the myocardial electrical activity disorder, arrhythmia or sudden death. In addition, HF patients with high power cycling and increased circulatory blood volume are also important factors in the development of DM. 1.1 diabetic cardiomyopathy Diabetic cardiomyopathy (DCM) is the 1 special process of myocardial disease, independent of myocardial ischemia and hypertension, and also different from primary cardiomyopathy. The incidence of male DM increased by 2 times, women increased by 5 times, and the relative risk of HF was 5 times as large as that of the 1 population. Pathological features of early DCM is the remnants of the non specific interstitial mononuclear cell degeneration, promote myocardial interstitial and perivascular fibrosis, by Schiff (PAS) - positive substance deposition, myocardial hypertrophy, myocardial microvascular basement membrane thickening and aneurysm form