糖尿病患者肺弥散功能的研究

目的 探讨糖尿病患者肺部微血管的改变.方法 对58例糖尿病患者和47例健康体检者进行肺通气功能及弥散功能检测,另对其中21例糖尿病患者和12例健康体检者进行肺泡毛细血管膜弥散功能(DM)和肺毛细血管血容量(Vc)测定.结果 糖尿病患者肺通气功能一秒率(FEV1/FVC)为(81.02±6.40)%,第1秒用力呼气量占预计值百分比(FEV1%)为(102.03±14.40)%,与健康对照组[FEV1/FVC:(81.20±6.96)%,FEV1%:(103.94±11.42)%]相比,差异均无统计学意义(t值分别为0.094、0.737,P均>0.05).糖尿病组一氧化碳弥散量(DLCO)为(18.14±5.92)ml/(mm Hg·min),一氧化碳弥散量占预计值百分比(DLCO%)为(72.79±19.85)%,较健康对照组[DLCO:(25.42±5.61)ml/(mm Hg·min),DL-CO%:(90.60±13.25)%]明显降低(t值分别为6.407、5.268,P均<0.01),病程≥10年的糖尿病患者DL-CO为(15.15±3.92)ml/(mm Hg·min),DLCO%为(64.69±17.49)%,较病程<10年的患者[DLCO:(21.14±6.12)ml/(mm Hg·min),DLCO%:(80.90±18.98)%]明显降低(t=4.435,-3.381,P均<0.01).糖尿病患者DM为(20.96±5.33)ml/(mm Hg·min),肺泡毛细血管膜弥散占预计值百分比(DM%)为(51.10±13.88)%,较健康对照组[DM:(42.92±13.14)ml/(mm Hg·min),DM%:(83.58±26.79)%]明显降低(t值分别为6.801、4.612,P均<0.01),而糖尿病组VC为(61.40±52.84)ml,肺毛细血管血容量占预计值百分比(VC%)为(78.05±64.40)%,与健康对照组[VC:(66.99±19.63)ml,VC%:(79.33±23.32)%]比较无明显差异(P均>0.05).结论 糖尿病患者肺弥散功能受损,与病程长短有关,随病程延长,弥散功能下降更加明显.糖尿病患者弥散功能受损以DM下降为主.

Investigation on pulmonary diffusing capacity of the patients with diabetes mellitus

Objective To investigate pulmonary capillary changes in patients with diabetes mellitus. Meth-otis Fifty-eight patients with diabetes mellitus were enrolled and forty-seven healthy subjects were taken as control. Diffusion capacity of carbonmonoxide (DLCO) and pulmonary ventilatory function were measured. DM and Vc were measured in twenty-one patients and twelve healthy subjects among them. Results FEV1/FVC was (81.02± 6.40) % in patients with diabetes mellitus and ( 81.20±6.96 ) % in controls, and FEV 1% was ( 102.03±14.40) in patients with diabetes mellitus and 103.94±11.42 in controls ,with no significant difference between patients with DLCO% was ( 72.79±19.85 ) % in patients with diabetes mellitus and ( 90.60±13.25 ) % in controls with a sig-patients whose course of disease was less than ten years,and DLCO% was (64.69±17.49)% in patients with dia-betes mellitus whose course of disease is equal or more than ten years and (80.90±18.98)% in patients whose course of disease is less than ten years,with significant difference between these two groups (t = 4.435, -3. 381, 13.88)% in patients with diabetes mellitas and (83.58±26.79)% in controls with a significant difference (t = 4. 612, P < 0.001 ). Vc was ( 61.40±52.84 ) ml in patients with diabetes mellitus and ( 66.99±19.63 ) ml in con-trols with no significant difference (P > 0.05 ), and Vc% was (78.05±64. 40)% in patients with diabetes mellitus and (79.33±23.32) % in controls, with no significant difference ( P > 0.05 ). Conclusions Diffusing capacity is decreased in patients with diabetes mellitus, which is related to the course of disease . DM decline is the main cause of DLCO decrease in patients with diabetes mellitus.