郑淑妹^1,,
王镇山^2,,
1. 厦门医学院附属第二医院 呼吸病院 呼吸肿瘤科, 福建 厦门 361021
2. 大连医科大学附属第二医院 呼吸科, 辽宁 大连 116027

详细信息 作者简介: 郑淑妹(1993-), 女, 住院医师。E-mail: 530907167@qq.com


通讯作者: 王镇山, 教授。E-mail: wzsdl@yahoo.com 中图分类号: R587.1


摘要:糖尿病（diabetes mellitus，DM）在中国具有很高的发病率，因肺脏具有广泛的微血管循环和丰富的结缔组织，导致其更易受到慢性高血糖的病理影响，从而可能成为DM的"靶器官"。近年来的研究表明，DM患者存在肺功能的改变，主要表现为限制性通气功能障碍和弥散功能障碍。DM患者具有更低的用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory volume in 1 second，FEV₁）、肺总量（total lung capacity，TLC）、肺活量（vital capacity，VC）、最高呼气流量（peak expiratory flow，PEF）、最大吸气压力和最大自主通气量（maximal voluntary ventilation，MVV），并且肺功能损害程度与血糖控制水平和糖尿病严重程度相关。目前考虑肺功能损害的主要机制包括胰岛素抵抗（insulin resistance，IR）、低度慢性炎症、肺泡毛细血管和肺小动脉微血管病变、累及呼吸肌的自主神经病变和肺实质胶原糖基化所引起的弹性回缩丧失。本文主要对DM患者肺功能的临床特征、肺组织的病理变化及肺功能损害的机制进行综述。
关键词: 糖尿病/
肺功能/
病理生理机制


Abstract:Diabetes mellitus (DM) has a high incidence in China. Lung parenchyma has rich microvascular circulation and abundant collagen and elastin fibers that could be affected by chronic hyperglycemia and make lungs the "target organ" of diabetes. In recent years, a large number of studies have shown lung function changes in patients with diabetes, mainly including restrictive ventilatory dysfunction and diffusion dysfunction. Patients with DM has lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), total lung volume (TLC), vital capacity (VC), peak expiratory flow (PEF), maximum inspiratory pressure and maximal voluntary ventilation (MVV). And the degree of lung function damage is related to the level of blood glucose and the severity of diabetes. At present, the main mechanisms considered for pulmonary function damage include insulin resistance (IR), low-grade chronic inflammation, microvasculopathy of alveolar capillaries and pulmonary arterioles, autonomic neuropathy involving respiratory muscles and loss of elastic retraction caused by collagen glycosylation in the lung parenchyma. Thus, this article mainly reviews the clinical characteristics of pulmonary function, the pathological changes of lung tissue and the mechanisms of pulmonary function damage in patients with diabetes.
Keywords:diabetes mellitus/
pulmonary function/
pathophysiological mechanism

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https://journal.dmu.edu.cn/data/article/export-pdf?id=dlykdxxb_20210314