慢性阻塞性肺疾病与胰岛素抵抗的临床研究

目的探讨慢性阻塞性肺疾病（COPD）与胰岛素抵抗（IR）的相关性。方法选择330例COPD患者，根据《慢性阻塞性肺疾病诊治指南》（2007年修订版）分为：轻度COPD组95例，中度COPD组95例，重度COPD组75例，极重度COPD组65例，并设正常对照组40例。取新鲜标本以全自动生化分析仪测定所有对象的空腹血糖、胰岛素、血脂，免疫比浊法测定尿白蛋白排泄率，电发光测定法测定胰岛素敏感指数（ISI）等指标。结果与正常对照组相比,各COPD组空腹血糖、血脂、尿白蛋白排泄率均显著升高,ISI显著降低(P均＜0.05)。与轻、中度COPD组相比，重度、极重度COPD组空腹血糖、血脂、尿白蛋白排泄率显著升高,ISI显著降低(P均＜0.05)。结论慢性阻塞性肺疾病的患者存在胰岛素抵抗，并随疾病程度的加重，胰岛素敏感性降低。

Clinical research of chronic obstructive pulmonary disease and insulin resistance

Objective To investigate the relativity of chronic obstructive pulmonary disease(COPD) and insulin resistance(IR). Methods A total of 330 cases of COPD were divided into four groups based on the chronic obstructive pulmonary disease diagno-sis and treatment guidelines (revised edition 2007) : 95 cases of mild COPD, 95 cases of moderate COPD, 75 cases of severe COPD, 65 cases of extremely severe COPD. 40 persons served as the normal controls. Fasting plasma glucose and insulin, blood lipids, urine albumin excretion rate, and insulin sensitivity index(ISI) were determined. Results Compared with the normal control group, fasting blood glucose, blood lipids, urinary albumin excretion rate in different COPD groups were significantly in-creased, while ISI was markedly reduced(P<0.05). Compared with the mild and moderate COPD groups, fasting blood glu-cose, blood iipids, urinary albumin excretion rate of the severe and very severe COPD groups were significantly increased, while ISI was significantly reduced (P<0.05). Conclusion Patients with chronic obstructive pulmonary disease have insulin resis-tance, and the more serious the disease, the lower the insulin sensitivity.