2型糖尿病患者肺功能变化及相关风险因素分析

Changes of pulmonary function and its related risk factors in T2DM patients

目的探讨T2DM患者肺功能变化及相关因素分析。方法对98例T2DM(T2DM组)患者和100名健康志愿者(NC组)进行肺功能检查,并对T2DM组肺功能变化的相关因素进行多因素线性回归分析。结果 T2DM组肺活量(VC)、用力肺活量(FVC)、一秒用力呼气流量(FEVl)、最大呼气峰流速(PEF)、最大自主通气量(MVV)、肺总量(TLC)、一秒率(FEV1/FVC)、肺一氧化碳弥散量(DL-CO)、肺单位体积一氧化碳弥散量(DLCO/VA)分别为(80.78±14.70)、(70.95±14.90)、(76.59±16.01)、(52.45±16.60)、(66.71±23.72)、(0.86±12.50)、(87.49±8.39)、(69.29±15.35)、(79.62±19.73),均低于NC组(P<0.05)。T2DM组DLCO与糖尿病病程(r=-0.45,P<0.05)、微血管病变积分(r=-0.37,P<0.05)、胰岛素抵抗指数(HOMA-IR)(r=-0.31,P<0.05)呈负相关。结论 T2DM组肺功能也存在损害,这种损害和糖尿病病程及糖尿病微血管慢性病变程度以及患者IR状态密切相关。

Objective To investigate the changes of pulmonary function and its related factors in T2DM patients. Methods The pulmonary functions were measured in 98 T2DM patients and 100 healthy subjects. A multiple linear regression analysis on the related factors for changes of pulmonary functions of T2DM patients was carried out. Results Compared with the control group, the vital capacity （VC）, forced vital capacity （FVC）, forced expiratory volume in first second （FEV1）, peak expiratory flow （PEF）, maximal voluntary ventilation （MVV）, total lung capacity （TLC）, second rate （FEV1/FVC）, diffusion capacity for carbon monoxide of lung （DLCO）, and DLCO corrected by alveolar volume （DLCO/VA） in the T2DM group were （80.78 ±14. 70）, （70.95 ± 14.90）, （76.59± 16. 01）, （52. 45±16.60）, （66.71±23.72）, （0. 86±12. 50）, （87.49±8. 39）, （69.29±15.35）, and （79.62± 19.73） respectively, significantly decreased （all P〈0. 05）. The simple correlation test showed that DLCO in the T2DM group was negatively correlated with the duration of diabetes （r=--0.45, P〈0. 05）, insulin resistance index （HOMA-IR） （r = -- 0. 37, P 〈 0.05）, and microangiopathy score （r = -- 0. 31, P 〈 0.05）. Conclusion The impaired pulmonary functions in T2DM patients indicate that the lung may also be the target organ of pathologic changes of diabetes. This impairment is closely related with the duration of diabetes, the severity of microangiopathy, and the insulin resistance state of the patient.