高血糖和胰岛素抵抗在肺动脉高压中的研究进展

摘要

肺动脉高压是由多种因素引起肺血管功能及结构性异常,导致肺血管阻力增加,引发肺循环血压异常升高的临床综合征,严重者可导致右心衰竭甚至死亡.而糖尿病是多种心血管疾病的重要危险因素,近年来其被认为与肺动脉高压存在相关性.其中,高血糖和胰岛素抵抗可以引起肺血管紧张性增高、血管内皮功能受损以及肺血管重构等,影响肺动脉高压进程.然而,现有的肺动脉高压分类系统难以反映高血糖和胰岛素抵抗造成的潜在影响.因此,未来需要更大型的研究及流行病学证据证实糖尿病与肺动脉高压之间的相关性,且有效的血糖控制在糖尿病及肺动脉高压患者中的作用也有待进一步研究.%Pulmonary hypertension is a common clinical syndrome characterized by dysfunction of pulmonary arterioles leading to increased vascular resistance and elevated pulmonary artery pressure,and even leads to right ventricular failure and death.Diabetes mellitus is recognized as a critical risk factor for cardiovascular disease,and it has been considered to be associated with pulmonary hypertension in recent years.Among them,hyperglycemia and insulin resistance can cause pulmonary vasoconstriction,endothelial dysfunction and vascular remodeling,which aggravate the progressive course of pulmonary hypertension.However,the existing classification system for pulmonary hypertension does not reflect the impact of hyperglycemia and insulin resistance.Therefore,larger research and epidemiological evidence are needed to confirm the correlation between diabetes and pulmonary hypertension in the future,and the role of effective glycemic control in patients with diabetes and pulmonary hypertension needs further study.