M型超声评价2型糖尿病患者膈肌运动异常

目的  探讨应用M型超声评价2型糖尿病（T2DM）患者膈肌运动异常。方法  将67例T2DM患者根据糖尿病病程分为两组，病程>10年为A组（32例），病程≤10年为B组（35例），正常对照组为C组（36例）。应用M型超声分别在平静呼吸，用鼻子用力深快呼吸，深呼吸时测量膈肌运动幅度，同时获得肺功能相关指标：一秒用力呼气量（FEV1）、一秒用力呼气容积预测值[FEV1（%） of predicted]、用力肺活量（FVC）、用力肺活量预测值[FVC（%） of predicted]、一秒用力呼气量占用力肺活量的百分数（FEV1/FVC）和肺活量（VC），并分析膈肌运动与肺功能的相关性。结果  平静呼吸时A、B、C组膈肌运动幅度差异无统计学意义（P >0.05）；用鼻子用力深快呼吸和深呼吸时膈肌运动幅度比较：A组0.05）；A、B、C组[FEV1（%） of predicted]、FVC、[FVC（%） of predicted]、FEV1/FVC（%）及VC组间比较差异无统计学意义（P >0.05）。A、B、C组在深呼吸时膈肌运动幅度均与FEV1、FVC及VC呈正相关（P <0.05）。结论  M型超声评价膈肌运动具有直接、便捷、非侵入性等优点，可以为糖尿病患者合并膈肌运动异常提供客观的诊断依据。

Evaluation of diaphragmatic motion abnormalities in patients of type 2 diabetes mellitus by M-mode ultrasonography

Objective To discuss the diagnostic value of M-mode ultrasonography in evaluating diaphragmatic motion abnormalities in the patients of type 2 diabetes mellitus (T2DM). Methods Sixty-seven patients of T2DM were enrolled and divided into group A (the course > 10 years, 32 cases) and group B (the course ≤ 10 years, 35 cases), and group C was normal control group (36 cases). M-mode ultrasonography was used to examine the diaphragmatic motion range of each group in quiet breathing, voluntary sniffing and deep breathing. The parameters of pulmonary function were obtained which included FEV1, FEV1 (% of predicted), FVC, FVC (% of predicted), FEV1/FVC (%) and VC. The correlations between the diaphragmatic motion range and the parameters of pulmonary function were analyzed. Results There were no significant differences in the diaphragmatic motion degree in quiet breathing among the groups A, B and C (P > 0.05). The diaphragmatic motion of the group A was smaller than that of the group B which was in turn smaller than that of the group C (P < 0.05) in volunntary sniffing and deep breathing. And so was it with group B and C (P < 0.05). The FEV1 of the group A was smaller than that of the groups B and C (P < 0.05). There was no significant difference in the FEV1 between the groups B and C (P > 0.05). There were no significant differences in the FEV1 (% of predicted), FVC, FVC (% of predicted), FEV1/FVC (%) or VC among the groups A, B and C (P > 0.05). The diaphragmatic motion range in deep breathing was positively correlated with the FEV1, FVC and VC (P < 0.05). Conclusions The diaphragmatic motion can be measured by M-mode ultrasonography directly, conveniently and noninvasively, which provides the objective diagnostic evidence for diaphragmatic motion abnormalities in the patients with T2DM.