2型糖尿病患者肺功能改变及影响因素的探讨

目的:观察2型糖尿病患者肺功能变化并分析其影响因素。方法:测定72例2型糖尿病患者和22例对照组肺功能。对糖尿病组肺功能变化进行相关分析及多元线性回归分析,其中19例患者予胰岛素强化治疗12周后,复测其肺功能,对比治疗前、后肺功能的变化。结果:糖尿病组肺活量(VC)、用力肺活量(FVC)、1秒钟用力呼气量(FEV1)、肺总量(TLC)和肺一氧化碳弥散量(DLco)均低于对照组(P<0.05或P<0.01)。相关分析表明,VC、FEV1、最大通气量(MVV)、TLC、单位肺泡容积的一氧化碳弥散量(DLco/VA)与年龄、病程、糖化血红蛋白(HbA1 c)和体质量指数(BM I)无显著相关性;DLco与病程呈显著性负相关(P<0.01)。多元线性回归分析表明,病程是DLco显著性独立预测因子。19例糖尿病患者予胰岛素强化治疗12周后,HbA1 c较治疗前降低(P<0.05),但DLco、DLco/VA仍显著降低(P<0.01)。结论:2型糖尿病患者存在肺通气功能及弥散功能损害,肺弥散功能损害主要与糖尿病病程有关,仅短期控制血糖对肺弥散功能无改善作用。

Pulmonary function in type 2 diabetes and its related factors

Objective: To explore the changes of pulmonary function in type 2 diabetes and its related factors.Methods: The pulmonary functions of 72 patients with type 2 diabetes and 22 healthy objects were measured,and the related factors,such as duration of DM,HbA1c,BMI,were analysed with linear regression analysis.Ninteen of them underwent a 12-week-long intensive insulin therapy and pulmonary function tests before and after the treatment.Results: Vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),total lung capacity(TLC) and carbon monoxide diffusion in the lung(DLco) were significantly decreased in the diabetes patients.Correlation analysis revealed that DLco was negatively correlated with the duration of DM.which was shown by linear regression analysis to be the only significant predictor.After a 12-week-long intensive insulin therapy,DLco and DLco/VA decreased significantly.Conclusion:Patients with type 2 diabetes have abnormal pulmonary ventilatory function and impaired pulmonary diffusive function,and the latter is related to the time of hyperglycemia,and can not ameliorated by short-term glycemic control.