【摘要】 糖尿病心肌病（DCM）是糖尿病心血管并发症，是独立于冠状动脉疾病、高血压及其他心血管疾病而发生的心室功能障碍以及心力衰竭。近年来，DCM的发病率呈逐年递增的趋势，严重影响糖尿病患者的生存质量，已成为重大的公共卫生问题，目前临床上仍未找到彻底有效的治疗药物。DCM发病机制复杂，由于糖脂质代谢失衡，氧化应激增加，钙稳态失衡，胰岛素抵抗，炎症反应激活等，造成心肌细胞和非心肌细胞损伤，最终发生心肌肥大和纤维化。DCM在临床上表现为收缩和（或）舒张功能障碍，最终发展为心力衰竭。线粒体自噬，细胞焦亡，铁死亡和铜死亡是近几年来糖尿病发病机制研究的热点。线粒体自噬受损致使活性氧水平增加，导致氧化应激，从而诱导细胞焦亡、铁死亡以及铜死亡，而DCM的发生与氧化应激密切相关。本文就线粒体自噬，细胞焦亡，铁死亡和铜死亡在DCM中的机制、作用、治疗等方面进行综述，以期为DCM的防治提供新思路。更多还原

【Abstract】 Diabetic cardiomyopathy(DCM) is a cardiovascular complication of diabetes, which is ventricular dysfunction and heart failure independent of coronary artery disease, hypertension and other cardiovascular diseases. Hypertension and other cardiovascular diseases. In recent years, the incidence of DCM has been increasing year by year, which has seriously affected the quality of life of diabetes patients and has become a major public health problem. At present, there is still no completely effective treatment drug in clinical practice. The pathogenesis of DCM is complex. Due to the imbalance of glycolipid metabolism, increased oxidative stress, calcium homeostasis imbalance, insulin resistance, activation of inflammatory response, etc. DCM is clinically characterized by systolic and/or diastolic dysfunction that eventually progresses to heart failure. Mitophagy, pyroptosis, ferroptosis and cuproposis have been the hotspots in the pathogenesis of diabetes in recent years. Damage to mitophagy leads to an increase in reactive oxygen species levels, leading to oxidative stress, which induces pyroptosis, ferroptosis, and cuproptosis, and the occurrence of DCM is closely related to oxidative stress. This article reviews the mechanism, role and treatment of mitophagy, pyroptosis, ferroptosis and cuproptosis in DCM, in order to provide new ideas for the prevention and treatment of DCM.更多还原