利拉鲁肽对2型糖尿病肺功能影响

40例糖化血红蛋白〉9％的2型糖尿病患者随机分为胰岛素组和利拉鲁肽组（n=20）,22例为对照,采用肺功能仪测定肺通气功能指标和DLCO（一氧化碳肺弥散功能）。结果与对照组相比,2型糖尿病患者的肺通气功能指标（VC、FVC、FEVl、TLC、MVV）和DLCO明显下降（P〈0．05）。12周后胰岛素组肺通气功能指标轻度增加,但无统计学意义,而弥散功能指标DLCO明显增加（P〈0．05）。利拉鲁肽组肺通气功能指标及弥散功能指标均明显高于胰岛素组（P值均〈0．05）。结论2型糖尿病血糖控制不良患者肺功能明显降低,与胰岛素比较,利拉鲁肽可明显改善2型糖尿病患者肺功能。     

2型糖尿病患者肺功能改变及影响因素研究

目的检测2型糖尿病患者的肺功能,探讨肺是否为糖尿病病变的靶器官。方法检测120例2型糖尿病患者和40例健康者的肺通气功能、弥散功能以及糖化血红蛋白（HbAlc）并进行比较,40例有并发症糖尿病患者给予胰岛素强化治疗4周后再次检测以了解治疗前后的肺功能变化。结果2型糖尿病组患者肺通气功能及弥散功能均较正常对照组明显降低（P〈0．05）,有并发症组肺通气功能及弥散功能较无并发症组明显降低（P〈0．05）,治疗后患者的一氧化碳弥散量（DLCO）及HbAlC较治疗前有所好转,并与变化相关。结论2型糖尿病患者肺功能受损,肺脏是糖尿病病变的靶器官之一,控制血糖是防治糖尿病患者肺功能损害的重要措施。     

天津地区严重急性呼吸综合征患者康复10年后肺功能状态

目的 评估严重急性呼吸综合征(SARS)患者康复10年后的肺功能恢复状况及SARS对患者肺功能的影响.方法 对本院2003年确诊为SARS的25例康复患者进行肺功能检测,分别测定肺总量、残气量、肺活量、用力肺活量(FVC)、FEV1、FEV1/FVC和肺一氧化碳弥散量(DLCO),并与2003年初始恢复期的肺功能指标进行自身对比.25例中男3例,女22例,年龄31 ～ 69岁,平均(45.8±12.2)岁.选取同期25名健康成人体检者,男6名,女19名,年龄31 ～ 62岁,平均(42.3±11.9)岁,对二者的肺功能指标进行对比分析.结果 25例中单纯弥散障碍2例,单纯限制性通气功能障碍2例,弥散障碍合并限制性通气功能障碍11例,弥散障碍合并阻塞性通气功能障碍1例.肺功能无异常患者10例.10年后和10年前主要的肺功能指标DLCO为(73±12)％和(72±15)％,FEV1/FVC为(83±11)％和(85±7)％,FEV1为(88±7)％和(86±14)％,FVC为(87±21)％和(87±17)％、残气量为(100±17)％和(78±30)％,各项指标比较差异均无统计学意义(均P＞0.05),同时与健康体检者比较差异均无统计学意义(均P＞0.05).结论 SARS患者康复10年后肺通气功能基本恢复正常,肺功能损害以弥散及限制性通气功能障碍为特征.     

糖尿病对慢性阻塞性肺疾病患者肺功能影响的相关性研究

目的观察糖尿病对于慢性阻塞性肺疾病(COPD)患者肺功能及血气分析情况的影响。方法回顾性分析2015年1月—2016年12月间在该院诊治的慢性阻塞性肺疾病(COPD)患者80例,根据有无合并糖尿病,分为试验组及对照组,通过肺功能检测及血气分析,测量VC、FVC、FEV1、FEV1/FVC、PEF、弥散量DLCO与比弥散量DLCO/PRED等肺功能指标,并进行组间比较,分析严重程度之间的差异。结果试验组肺功能指标显著低于对照组。试验组的疾病严重程度也高于对照组患者,差异有统计学意义(P0.05)。结论慢性阻塞性肺疾病(COPD)患者合并糖尿病时,其的肺功能受损情况更严重,COPD合并糖尿病时肺通气功能和弥散功能都可受损。     

2型糖尿病患者肺功能变化及其相关因素分析研究

目的探讨2型糖尿病患者肺功能变化及其相关因素。方法用肺功能指标测定入选74例2型糖尿病患者（糖尿病组）的肺功能并同时测定三酰甘油、胆固醇、C反应蛋白、同型半胱氨酸、脂蛋白a、空腹血糖、空腹胰岛素、糖化血红蛋白（HbA1 c）检查以及尿蛋白排泄率（AER）检测、眼底检查以及神经传导速度检查,计算胰岛素抵抗指数;74例无糖尿病患者为对照组完成9个月的观察,比较两组肺功能变化,并对糖尿病组肺功能变化的相关因素进行多因素线性回归分析。结果糖尿病组肺活量（VC）、1s用力呼气容积（FEV1）、肺总量（TLC）、最大自主通气量（MVV）、肺-氧化碳弥散量（DLCO）、肺单位体积-氧化碳弥散量（KCO）均明显低于对照组（P〈0.05）。对糖尿病组进行线性相关分析表明,VC、FEV1、TLC均与HbA1 c呈显著负相关（P〈0.01）,且VC与同型半胱氨酸呈显著负相关（P〈0.05）,MVV与微血管并发症积分呈显著相关性（P〈0.01）。DLCO、KCO均与HbA1 c、微血管并发症积分呈负相关（P〈0.05）,DLCO亦与胰岛素抵抗指数呈显著负相关（P〈0.05）,并对糖尿病患者肺功能指标与多种相关因素进行多因素线性回归分析。结论 2型糖尿病患者存在肺通气功能及弥散功能减退,肺脏可能是糖尿病慢性病变的靶器官之一,控制血糖、改善胰岛素抵抗、抗氧化应激治疗是其防治重点。     

不同阶段2型糖尿病患者肺功能分析

目的通过对不同阶段2型糖尿病患者的肺功能进行分析,以明确糖尿病患者是否存在肺功能损害。方法对60例2型糖尿病患者(初发糖尿病患者30例,合并不同并发症患者30例)和60例健康志愿者分别进行肺功能检测,检测其用力肺活量(FVC)、1秒钟用力呼气容积(FEVI)、1秒率(FEVl/FVC)、肺一氧化碳弥散(DLCO)及单位肺泡一氧化碳弥散量(DLCO/VA)肺功能指标数据,采用SPSS17.0软件进行统计学处理,分析不同阶段2型糖尿病患者的肺功能变化。结果糖尿病组FVC、DLCO及DLCO/VA低于健康对照组,差异有统计学意义(P0.05);且有并发症组较无并发症组以上各项指标进一步下降,差异有统计学意义(P0.05)。结论糖尿病患者肺功能减退,且以弥散功能下降显著,且随疾病进展,糖尿病出现并发症的患者肺弥散功能更加减退,积极控制血糖,延缓并发症的产生,可进一步减缓肺功能的减退。     

恢复期SARS患者肺功能的改变

目的 观察SARS患者恢复期肺功能状况，评价SARS对患者肺功能的影响。方法 SARS组10例，对照组13例，分别测定肺活量(VC)、用力肺活量(FVC)、一秒钟用力呼气容量与用力肺活量比值(FEVl．0％)、25％～50％肺活量位最大呼气流量(V25％～50％)、残气量(RV)和肺一氧化碳弥散量(DLCO)。结果 SARS组VC、FVC和DLCO均显著低于对照组。结论 SARS患者肺功能受到损害，主要以限制性通气功能障碍和弥散功能损害为特征。对SARS患者作肺功能检查能及时了解和评估患者的肺功能状况。     

肺泡蛋白沉着症患者的肺功能与胸部分辨率CT的相关性

目的 探讨PAP患者的肺功能与高分辨率CT定量测量指标之间的相关性.方法 对2004至2007年在广州医学院第一附属医院呼吸疾病研究所住院的17例PAP患者(男10例,女7例,年龄15～51岁)进行肺通气及弥散功能检查和高分辨率CT检查,分析肺功能指标与高分辨率CT定量指标之间的相关性.比较其中6例行全肺肺泡灌洗治疗前、后的肺功能和高分辨率CT定量指标的变化.采用SPSS 13.0软件进行数据处理,结果 以x±s表示.结果 PAP患者的肺功能检查结果 以限制性通气功能障碍和弥散功能下降为主,弥散功能下降更为显著,DLCO占预计值%为(46±22)%,异常率为94.1%.肺功能检查结果 与高分辨率CT定量检查结果 之间存在一定的相关性,其中平均肺密度与FVC、肺重量与FEV1、肺含气容积比与呼气峰流量、DL.CO、DLCO与肺泡通气量比值(DLCO/VA)等指标的改变差异有统计学意义,(r值分别为-0.469、-0.482、0.511、0.659、0.692,均P<0.05),在所有指标中以肺含气容积比与DLCO/VA关系最为密切.6例肺泡灌洗术治疗的患者术后肺功能和高分辨率CT定量测量指标有所改善.结论 PAP的肺功能和胸部高分辨率CT改变之间存在相关性.2项检查同时进行可作为PAP患者随访的重要参考指标.     

肺泡蛋白沉着症肺功能检查特点:附27例分析

目的 肺泡蛋白沉着症(PAP)在临床上极为罕见,其肺功能检查特点的报道也极少,本研究目的在于探讨肺功能检查在PAP诊断和治疗中的价值.方法 回顾性分析本院呼吸疾病研究所经肺组织病理(过碘酸雪夫反应阳性)确诊的27例PAP患者的临床资料.全部病例均给予肺通气和弥散功能测试,其中12例进行了肺容积测试.比较了10例行支气管肺泡灌洗(BAL)治疗的患者在灌洗前、后肺功能的改变情况.结果 27例患者入院后的基础通气肺功能情况:用力肺活量(FVC):(79.67±16.21)%;第1秒用力呼气容积(FEV1):(83.94±16.07)%,一秒率(FEV1/FVC):(89.20±5.50)%;最大呼气流量(PEF):(107.64±17.73)%;肺一氧化碳弥散量(DLCO):(49.27±21.83)%;DLCO与肺泡通气量比值(DLCO/VA):(69.92±20.11)%.肺总量(TLC):(80.60±19.56)%;残气容积(RV):(86.03±38.10)%;残总比(RV/TLC):(32.73±9.48)%;功能残气量(FRC):(84.91±28.08)%.27例患者基础肺功能下降的异常率:FVC:55.6%(15例);FEV1:44.4%(12例);FEV1/FVC:0%(0例);PEF:3.7 %(1例);DLCO:88.9%(24例);DLCO/VA:70.4%(19例).12例患者肺容积的异常率:TLC下降者占50%(6例);RV下降者占41.7%(5例),升高者占16.7%(2例);RV/TLC升高者占50%(6例);FRC下降者占33.3%(4例).10例进行BAL治疗的患者术后肺功能改善率:FVC:5.47%;FEV1:5.50%;DLCO:31.07%;DLCO/VA:20.35%.灌洗前后DLCO及DLCO/VA差异有统计学意义(t=-3.551,-3.159;P=0.006,0.012).结论 PAP的肺功能检查以肺限制性通气功能障碍及肺弥散功能障碍为常见,尤其为弥散功能障碍.PAP经BAL治疗后肺弥散功能有显著性改善.     

33例1型糖尿病患者肺功能观察

目的 观察1型糖尿病患者的肺功能改变。方法 应用美国2100型肺功能仪对33例1型糖尿病患者及30例健康正常人的肺功能,包括VC、VC％、FEV1％、FEF25％－75％、DLCO、DLCO％6个指标进行了检测。结果 1型糖尿病患者肺通气功能正常,小气道功能轻度受损,与健康人相比无显著差异（P＞0．05）,糖尿病患者肺弥漫功能（DLCO％）明显低于正常对照组（P＜0．01）,且随病程延长及合并症的增多肺弥漫功能减退更为明显（P＜0．05）。结论 1型糖尿病可以导致肺弥漫功能减退,且同病程的延长及合并症的增加呈正相关。     

Correlation between the function and structure in papain-induced emphysema in dogs

To examine the relationship between morphologic changes and the alteration of pulmonary function, papain solution was administered to 11 dogs by inhalation and to 5 dogs by a single intratracheal injection. Pulmonary function tests, including determination of lung volume subdivision, diffusion capacity (DLCO), pressure-volume relationship of the lung and arterial blood gas were performed before and after papain treatment. The dogs were then killed and the lungs processed for pathologic studies. The severity of emphysema was graded as percent of emphysema according to Dunill's method and we compared this to the antemortem pulmonary function data. Exponential constant K was determined by fitting lung pressure-volume data to the equation V = Vo (1-e-KP). After papain administration, DLCO decreased, K of the pressure-volume curve increased, and arterial blood oxygen pressure reduced significantly. The changes of residual volume, the ratio of residual volume to total lung capacity, DLCO per unit lung volume, and the values of the exponential functions of pressure-volume data were correlated with the severity of emphysema with statistical significance, but none of them showed excellent order correlation. Multiple regression equation using 2 to 4 of the parameters indicated that the severity of emphysema can be predicted more accurately. We conclude that recognition of the severity of emphysema requires a multivariate approach including the determination of lung volume, DLCO, and pressure volume relationship of the lung, because the relationship between the severity of emphysema and the values obtained with these measurements are nonlinear.     

Abnormal pulmonary function in adults with sickle cell anemia

RATIONALE: Pulmonary complications of sickle cell anemia (Hb-SS) commonly cause morbidity, yet few large studies of pulmonary function tests (PFTs) in this population have been reported. Objectives: PFTs (spirometry, lung volumes, and diffusion capacity for carbon monoxide [DLCO]) from 310 adults with Hb-SS were analyzed to determine the pattern of pulmonary dysfunction and their association with other systemic complications of sickle cell disease. METHODS: Raw PFT data were compared with predicted values. Each subject was subclassified into one of five groups: obstructive physiology, restrictive physiology, mixed obstructive/restrictive physiology, isolated low DLCO, or normal. The association between laboratory data of patients with decreased DLCO or restrictive physiology and those of normal subjects was assessed by multivariate linear regression. MEASUREMENTS AND MAIN RESULTS: Normal PFTs were present in only 31 of 310 (10%) patients. Overall, adults with Hb-SS were characterized by decreased total lung capacities (70.2 +/- 14.7% predicted) and DLCO (64.5 +/- 19.9%). The most common PFT patterns were restrictive physiology (74%) and isolated low DLCO (13%). Decreased DLCO was associated with thrombocytosis (p = 0.05), with hepatic dysfunction (elevated alanine aminotransferase; p = 0.07), and a trend toward renal dysfunction (elevated blood urea nitrogen and creatinine; p = 0.05 and 0.07, respectively). Conclusions: Pulmonary function is abnormal in 90% of adult patients with Hb-SS. Common abnormalities include restrictive physiology and decreased DLCO. Decreased DLCO may indicate more severe sickle vasculopathy characterized by impaired hepatic and renal function.     

Evaluation of diffusing capacity in patients with a restrictive lung disease

BACKGROUND: In healthy volunteers, the single-breath diffusing capacity of the lung for carbon monoxide (DLCO) decreases and DLCO normalized per liter alveolar volume (VA; DLCO/VA) increases if VA is decreased. We hypothesized that comparison of DLCO/VA with its predicted value at predicted total lung capacity (TLC) will result in an underestimation of the diffusion disorder in patients with a restrictive lung disease, if a similar relationship exists between DLCO/VA and lung volume as found in healthy volunteers. OBJECTIVE: To test this hypothesis, we studied total gas transfer DLCO and DLCO/VA as functions of VA in patients who developed a restrictive lung disease and a diffusion disorder in a short period of time. DESIGN: An observational survey. SETTING: Pulmonary function department. PATIENTS: Thirteen patients without any initial pulmonary pathology who developed the mentioned pulmonary pathology due to bleomycin treatment. INTERVENTIONS: Bleomycin treatment. MEASUREMENTS AND RESULTS: We performed the single-breath test at various VA levels before, during, and after bleomycin treatment. In the majority of the patients, the DLCO vs VA relationship remained parabolic, but shifted downwards during therapy. Therefore, the linear DLCO/VA vs VA relationship shifted downwards, while the negative slope was not changed, indicating the development of a decreased gas transfer. Six patients also developed a volume restriction. CONCLUSIONS: The agreement of the data with the hypothesis increased its probability. Consequently, to evaluate a diffusion disorder, DLCO/VA at a lower actual TLC of patients with a lung restriction should be compared to a reference DLCO/VA at a lung volume equal to the actual TLC.     

对2型糖尿病患者肺功能变化及其相关因素的临床分析

目的分析2型糖尿病患者肺功能变化的影响因素。方法选取该院2018年10月—2019年5月期间收治的62例2型糖尿病患者以及同期于该院接受体检的60名健康体检者作为研究对象,分别作为观察组和对照组,对比两组受检者各项肺功能指标的差异,分析糖化血红蛋白(HbA1c)水平、微血管并发症积分以及胰岛素抵抗指数(HOMA-IR)对于肺功能变化的影响。结果与对照组健康体检者相比,观察组2型糖尿病患者的肺活量(VC)、1 s用力呼气容积(FEV1)、肺总量(TLC)、最大自主通气量(MVV)、肺一氧化碳弥散量(DLCO)、肺单位体积一氧化碳弥散量(KCO)相对更低,差异有统计学意义(P<0.05)。在62例2型糖尿病患者中,HbA1c>8.5%、微血管并发症积分>2分以及HOMA-IR>2患者的VC、FEV1、TLC、DLCO以及KCO等指标相对更低,差异有统计学意义(P<0.05)。结论根据2型糖尿病患者的HbA1c水平、微血管并发症积分以及HOMA-IR,准确判断肺通气功能及弥散功能减退的实际情况,能够为肺部并发症的防治提供参考。     

INCREASE OF PULMONARY DIFFUSING CAPACITY IN SYSTEMIC SCLEROSIS

Pulmonary function tests and chest radiographs of 29 non-smokingsystemic sclerosis (SSc) patients were analysed, featuring anapparently paradoxic finding of an increased diffusing lungcapacity for carbon monoxide (DLCO). Twenty-one patients (72%)had abnormal pulmonary function, 11 of them had restrictivedisease (38%), six (21%) had isolated DLCO increase, four(14%)had isolated DLCO reduction, while two patients had obstructivedisease (7%). Chest X-ray revealed interstitial abnormalitiesconsistent with pulmonary fibrosis in all four patients withisolated DLCO reduction, in one obstructive patient and in sixrestrictive patients. Inpatients with DLCO increased steroidtreatment significantly reduced DLCO (P<0.05) and membraneDLCO component (Dm) (P<0.05). Hitherto unobserved findingof DLCO increase in SSc patients was associated with shorterduration of SSc (P<0.05), normal lungmechanics and roentgenogram(P<0.05) and absence of pulmonary symptoms (P<0.05). Thefindings that in some SSc patients DLCO increases suggest thatDLCO might prove to be an early and sensitive indicator of acutepulmonary involvement. KEY WORDS: Scleroderma, Pulmonary function tests, Pulmonary diffusing capacity, Memebrane diffusing capacity, Pulmonary capillary blood volume, Corticosteroids     

The effect of thoracentesis on lung function and transthoracic electrical bioimpedance.

This study aimed to determine the relationship between improvement in lung function and changes in transthoracic electrical bioimpedance (TEB) after thoracentesis in patients with pleural effusions. Fifteen patients with pleural effusions due to either malignant (n = 8) or cardiac (n = 7) diseases were included. Pulmonary function was assessed before and after thoracentesis. During thoracentesis the patients were monitored with TEB. Using linear correlation analysis, the increases for each litre of aspirated thoracic fluid were: forced expiratory volume in 1 s (FEV1) 0.261; forced vital capacity (FVC) 0.331; total lung capacity (TLC) 0.58; and the lung diffusing capacity (DLCO); 2.4 ml min-1 mmHg-1. Baseline impedance increased by 2.3 Ohm l-1 aspirated thoracic fluid. The relative increase in baseline impedance was twice as high for patients with cancer as for patients with heart failure (P < 0.05). We found only minor changes in systolic blood pressure and mean arterial pressure. The improvements in diffusing capacity, airflow, and lung volumes after thoracentesis are correlated to an increase in baseline impedance, but changes are dependent on the primary disease.     

Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes

Background In Type 1 diabetes mellitus (DM), it has been suggested that autonomic nervous system dysfunction (NAD) impairs lung diffusion capacity. Heart rate variability (HRV), a measure of cardiac autonomic function, is a sensitive method of detecting NAD. To our knowledge, no previous study has assessed whether cardiac sympatho‐vagal balance is associated with lung diffusion capacity in diabetes. Methods Twenty Type 1 DM patients without pulmonary abnormalities and systemic NAD underwent measurement of lung diffusion capacity for carbon monoxide (DLCO) by single‐breath method and assessment of cardiac autonomic function by HRV analysis on 24‐h electrocardiographic Holter recordings. Results Standard respiratory function tests and peripheral autonomic tests were normal in all patients. DLCO was lower than normal reference values in six patients (30%). DLCO correlated significantly with most HRV variables, independent of the clinical and laboratory variables. The strongest correlation was found with standard deviation of all RR intervals (SDNN; r = 0.62, P = 0.003) in the time domain and low frequency (LF) power (r = 0.73, P < 0.001) in the frequency domain. Conclusions In Type 1 diabetes, a significant association exists between cardiac NAD and reduced DLCO in the absence of clinical respiratory and autonomic abnormalities. Thus, NAD may be involved in the early reduction of DLCO in these patients, possibly through abnormalities in the regulation of pulmonary blood flow at the microvascular level.     

Pulmonary function abnormalities in chronic severe cardiomyopathy preceding cardiac transplantation.

Pulmonary function data, including diffusing capacity, were evaluated in 56 patients with chronic severe cardiomyopathy before heart transplantation. Cardiac catheterization data were used to describe the relationship between cardiac and pulmonary function. Of 56 patients 44 had some abnormality in pulmonary function. The majority, 30 of 56, had a restrictive impairment alone. Of 28 patients in whom diffusing capacity was measured, 64% had a diffusion impairment. There was no association of pulmonary function impairment with type of cardiomyopathy or smoking history. Pulmonary capillary wedge pressure correlated positively with DLCO, but not with FVC or TLC. Cardiac index and ejection fraction did not correlate with diffusing capacity. This precardiac transplantation cardiomyopathy patient group demonstrated frequent pulmonary function abnormalities not previously recognized.     

The Relationship Between Severity of Liver Cirrhosis and Pulmonary Function Tests

Pulmonary complications, mainly hepatopulmonary syndrome (HPS), are frequently observed in liver cirrhosis. In this study, the aim was to investigate the frequency of hypoxemia and impairment of pulmonary function tests (PFT) in patients with liver cirrhosis and to examine the relationships of these impairments with liver failure. A total of 39 patients with cirrhosis, 24 males and 15 females, were included in our study. The mean age of the patients was 47.5 +/- 17.2 years. Arterial blood gases, PFT, and carbon monoxide diffusion tests (DLCO) were performed in all patients. Out of 39 cirrhotic patients, 21 (53.8%) had ascites, whereas 18 (46.2%) did not. Seven patients were in the Child-Pugh A group, 21 in the Child-Pugh B group, and 11 patients were in the Child-Pugh C group. Hypoxia was found in 33.3% of the patients. Although the PaO2 and SaO2 values of patients with ascites were lower compared to those without ascites (P < 0.05), no statistically significant difference was determined in the comparison of hypoxia between the groups (P > 0.05). Among the PFT parameters, FEV1/FVC and FEF25-75% values were found to be lower in patients with ascites than those without (P < 0.05). No differences were established between these two groups of patients in terms of DLCO (P > 0.05). While no differences were found in comparison of the DLCO values in between the groups (P > 0.05), there was a statistically significant difference in the ratio of DLCO to the alveolar ventilation (DLCO/VA) in between the groups (P < 0.05). On the other hand, a negative correlation was found between the DLCO/VA and Child points when the relationship between the Child-Pugh score and PFT parameters were investigated (r = -0.371, P < 0.05). Consequently, a relationship was established between the severity of liver failure and diffusion tests showing pulmonary complications invasively. We believe diffusions tests should be performed in addition to the PFT in order to determine pulmonary involvements particularly in patients who are candidates for liver transplantation.