糖尿病致肺损伤的相关机制及降糖药对肺疾病的影响

Related Mechanism of Lung Injury Caused by Diabetes Mellitus and the Effect of Hypoglycemic Drugs on Pulmonary Disease

肺脏具有丰富的结缔组织和微血管循环,故易受到高血糖的影响。目前,肺功能降低与糖尿病的关系尚未完全明确。笔者分析国内外相关文献发现,糖尿病致肺损伤的可能病理生理机制包括胰岛素抵抗、低级别炎症、微血管病变、累及呼吸肌的神经病变及蛋白质非酶糖基化;此外,除胰岛素之外的大多数降糖药被证实可以通过减轻炎症、降低气道高反应性、促进癌细胞凋亡等机制而对肺疾病产生积极影响,而胰岛素可能对肺疾病产生消极影响,这对糖尿病合并肺疾病患者的治疗具有一定参考价值。

Because of its rich connective tissue and microvascular circulation,the lung is susceptible to the effects of hyperglycemia.At present,the relationship between pulmonary function reduction and diabetes mellitus has not been fully clarified.By analyzing the relevant literature at home and abroad,the author found that the possible pathophysiological mechanisms of diabetes mellitus-induced lung injury include insulin resistance,low-grade inflammation,microvascular disease,neuropathy involving the respiratory muscle and protein non-enzymatic glycosylation.In addition,most hypoglycemic agents except insulin have been proved to have a positive impact on lung diseases by reducing inflammation,reducing airway hyperresponsiveness,and promoting apoptosis of cancer cells,while insulin may have a negative impact on lung diseases,which has a certain reference value for the treatment of diabetes mellitus patients complicated with lung diseases.