糖尿病患者肺功能状况观察

背景目前糖尿病的发病率有上升的趋势,有关糖尿病患者肺功能状况的报道较少.目的对比观察糖尿病患者与正常人肺功能状况的差异,探讨糖尿病病程与肺功能改变之间的关系.设计病例对比观察.单位武汉大学人民医院.对象选择2000-01/2003-12在武汉大学人民医院就诊的糖尿病患者90例,均自愿参加观察.胰岛素依赖型20例,非胰岛素依赖型70例.另外将90例患者以10年病程为界分为2组,病程小于10年组40例,病程大于10年组50例.选择肺功能正常人30例为健康对照组,均为积极参与本课题的志愿者.方法分别测定各组观察对象的肺功能指标肺活量、用力肺活量、第1秒用力呼气容积占用力肺活量比值、呼气流速峰值及最大通气量,并进行对比分析.主要观察指标①各组观察对象血气分析和肺功能状况比较.②不同病程糖尿病患者的肺功能状况比较.结果①各组观察对象血气分析和肺功能状况比较与健康对照组比较,糖尿病组患者的肺活量、用力肺活量和肺通气功能都显著下降(t=1.999～2.301,P＜0.05).胰岛素依赖型与非胰岛素依赖型糖尿病患者的肺活量、用力肺活量、肺通气功能比较,差异无显著性意义(P＞0.05).②不同病程糖尿病患者的肺功能状况比较病程＞10年组糖尿病患者的肺功能状况明显劣于病程＜10年组患者[肺活量(L)2.62±0.65,3.25±1.25;用力肺活量(L)2.40±0.52,3.21±0.98;第1秒用力呼气容积占用力肺活量比值75.31±2.31,80.63±5.56;呼气流速峰值(L/s)4.33±0.68,5.98±1.02;最大通气量(L/s)76.22±6.98,89.21±5.69(t=2.012～2.350,P＜0.05)].结论糖尿病患者的肺功能较正常人有减退的倾向,且病程较长的患者肺功能下降明显,临床工作中应予以密切重视.

Observation of pulmonary function in patients with diabetes mellitus

BACKGROUND: The morbidity of diabetes mellitus increased recently.There are few reports about the pulmonary function status of the patients with diabetes mellitus.OBJECTIVE: To comparably observe the difference of the pulmonary function status between patients with diabetes mellitus and normal persons,and to probe into the relationship between the course of disease of diabetes mellitus and the functional change of pulmonary function.DESIGN: Case controlled observation SETTING: Renmin Hospital, Wuhan University PARTICIPANTS: Totally 90 patients with diabetes mellitus hospitalized in the Renmin Hospital, Wuhan University between January 2000 and De cember 2003 were recruited. All the patients participated in the experiment voluntarily. Totally 20 cases were of insulin dependent diabetes mellitns (IDDM) and 70 cases were of non-insulin dependent diabetes mellitus (NIDDM). Another 90 cases were divided into 2 groups with the boundary line of 10 years: group with disease course ＜10 years (n=40) and group with disease course ＞10 years (n=50). And 30 normal persons with healthy pulmonary function was set as healthy control group, all the testees were voluntary participants in the experiment.METHODS: Pulmonary function index of the participants of each group was measured: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1%), peak expiratory flow rate(PEFR)maximal voluntary ventilation (MVV) and comparison was performed between them.Comparison of the pulmonary function status of the patients between different levels of diabetes mellitus.pulmonary function between different groups : Compared with health control group, VC , FVC and MVV of the patients with diabetes mellitus was significantly decreased (t=1.999-2.301, P ＜ 0.05).There was no significant difference in the VC, FVC and MVV between patients with monary function between patients with different diabetes mellitus: the pulmonary function status in the group with disease course ＞10 years was improved less than that in the group with disease course ＜10 years [ VC (L):2.62±0.65 vs 3.25±1.25;FVC(L): 2.40±0.52 vs 3.21±0.98;FEV1%:75.31±2.31 vs 80.63±5.56;PEFR (L/s):4.33±0.68 vs 5.98±1.02;MVV (L/s): 76.22±6.98 vs 89.21±5.69 (t=2.012-2.350, P ＜ 0.05)].CONCLUSION: Pulmonary function of the patients with diabetes mellitus has reduced tendency compared with the normal persons, and the pulmonary function of the patients with long course of disease decreases significantly. More attention should be paid to diabetes patients' pulmonary function changes.