慢性阻塞性肺疾病合并2型糖尿病的老年患者肺功能、免疫失衡研究

目的 探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并2型糖尿病(type 2 diabetes mellitus,T2DM)老年患者的肺功能、免疫水平变化及其临床意义.方法 选取北京市垂杨柳医院2015年1月至2016年1月收治的120例COPD患者进行研究,其中合并T2DM患者48例(T2DM组)、单纯COPD患者62例(单纯COPD组),比较两组患者肺功能、免疫指标的差异.结果 T2DM组的CD3+、CD4+、CD4+/CD8+测定值均低于单纯COPD组患者(t=4.209、t=4.598、t=5.617,P<0.05),T2DM组CD8+测定值高于单纯COPD组(t=4.157,P<0.05);T2DM组的血清IFN-γ、IL-10的水平均显著的低于单纯COPD组患者(t=4.839、t=8.529,P<0.05),T2DM组的血清IL-4、IL-8的水平高于单纯COPD组(t=4.209、t=4.517,P<0.05);T2DM组的用力肺活量(forced vital capatiry,FVC)、用力呼气容积(forced expiratory volume in 1 second,FEV lung for carbon monoxide,DLCO)水平均显著的低于单纯COPD组患者(t=3.006、t=5.966,t=6.210,P<0.05).结论 老年COPD合并T2DM患者的肺功能损害更加严重,可能与炎症反应水平增强及免疫失衡有关.

Study on the imbalance of lung function and immunity level in elderly patients with chronic obstructive pulmonary disease combined with type 2 diabetes mellitus

Objective To investigate the changes of pulmonary function,immune activity,and clinical significance in elderly patients with chronic obstructive pulmonary disease(COPD)combined with type 2 diabetes mellitus(T2DM). Methods 120 COPD patients,in which 48 patients also have T2DM(T2DM group),were stud-ied in our hospital from January 2015 to January 2016. Patients'pulmonary function,immune index was compared and analyzed. Results The ratio of cells with CD3 +,CD4 + and CD4 + / CD8 + in T2DM group was significantly lower than that in the patients with COPD only(t =4. 209,t =4. 598,t =5. 617,P <0. 05),while the ratio of cells with CD8 + was higher than that in patients with COPD only(t = 4. 157,P < 0. 05). Moreover,serum IFN-γ and IL-10 in patients with COPD combined with T2DM were significantly lower than that in patients with only COPD (P <0. 05). IL-4 and IL-8 levels in patients with COPD combined with T2DM were higher than that in patients with only COPD(t =4. 839,t =8. 529,P <0. 05). Furthermore,forced vital capatiry(FVC),forced expiratory vol-ume in 1 second(FEV 1 ),and diffasing capacity of the lung for carbon monoxide(DLCO)levels in COPD patients combined with T2DM were significantly lower than that of the patients with only COPD(t =3. 006,t = 5. 966,t =6. 210,P <0. 05). Conclusion Elderly COPD patients combined with T2DM showed worse lung function,which could be associated with increased inflammatory response and immune imbalance.