胰岛素抵抗及肺动脉高压关系的研究进展.PDF

J South Med Univ, 2015, 35(2): 301-305 doi 10.3969/j.issn. 1673-4254.2015.02.31 ·301 · 综述 胰岛素抵抗与肺动脉高压关系的研究进展胰岛素抵抗与肺动脉高压关系的研究进展 柯 蕊，吴媛媛，王贵佐，李满祥 西安交通大学医学院第二附属医院呼吸病研究室//呼吸内科，陕西 西安 710004 摘要：肺动脉高压是由多种因素引起的肺血管功能及结构性异常，导致肺血管阻力增加，引发肺动脉压力升高的临床综合征。 胰岛素抵抗是多种心血管疾病的重要危险因素之一，但其与肺动脉高压的关系直到近几年才受到关注。研究发现胰岛素抵抗 及其伴发的高胰岛素血症、血脂紊乱、炎症反应和氧化应激，可引起肺血管紧张性增高、血管内皮功能受损以及肺血管重塑等， 与肺动脉高压的发生、发展密切相关。因此，采取多种措施改善胰岛素抵抗对预防和治疗肺动脉高压具有重要意义。 关键词：肺动脉高压；胰岛素抵抗；胰岛素 Research progress in the correlation between insulin resistance and pulmonary arterial hypertension KE Rui, WU Yuanyuan, WANG Guizuo, LI Mangxiang Respiratory Disease Research Center, Department of Respiratory Medicine, Second Affiliated Hospital, Xian Jiaotong University College of Medicine, Xian 710004, China Abstract: Pulmonary arterial hypertension (PAH) is a common clinical syndrome characterized by dysfunction of pulmonary arterioles leading to increased vascular resistance and elevated pulmonary artery pressure. Insulin resistance (IR) is recognized as a critical risk factor for cardiovascular disease, but recent evidence suggested an association between IR and PAH. The pathological consequences of IR, such as hyperinsulinemia, dyslipidemia, chronic inflammation, and oxidative stress can cause pulmonary vasoconstriction, endothelial dysfunction and vascular remodeling, which aggravate the progressive course of PAH. Therefore, addressing the molecular mechanisms by which IR promotes the development of pulmonary hypertension and searching for appropriate interventions are important in the management of PAH. Key words: pulmonary arterial hypertension; insulin resistance; insulin 胰岛素抵抗（insulin resistance, IR）是指胰岛素作 胰岛素以克服IR 和高血糖水平，由此产生的高胰岛素 用的靶器官对外源性或内源性胰岛素作用的敏感性降 血症是IR 的重要标志。IR 的发生与胰岛素受体、受体 低，为维持正常血糖，机体代偿性地增加胰岛素分泌，引 前和受体后信号转导异常有关。此外，衰老、缺乏锻炼、 起高胰岛素血症。IR 是多种疾病，如代谢综合征、心血 肥胖等也会导致IR 的发生。IR不仅是多种病理生理状