2型糖尿病患者肺弥散功能检测分析

Analysis of Pulmonary Diffusion Capacity in Patients with Type 2 Diabetes Mellitus

【目的】检测2型糖尿病患者的肺通气和弥散功能,探讨肺是否为糖尿病慢性病变的靶器官。【方法】检测107名2型糖尿病患者行肺通气及弥散功能,与61名健康者相比较。糖尿病患者行糖化血红蛋白(HbA1c)、尿白蛋白排泄率(AER)检测、眼底检查以及神经传导速度检查,以评价血糖控制水平以及糖尿病微血管病变状况。具有糖尿病视网膜病变、糖尿病肾病、糖尿病周围神经病变者各记1分,总分以微血管病变积分表示。【结果】2型糖尿病组肺通气功能与正常对照组相比,差异无统计学意义。2型糖尿病组一氧化碳弥散量(DLCO)及单位肺泡容积的一氧化碳弥散量(DLCO/VA)较对照组明显降低(P<0.05)。DLCO、DLCO/VA与微血管病变积分呈负相关(r分别为-0.291、-0.324,P<0.01)。DLCO/VA与年龄、病程呈负相关(r分别为-0.269、-0.236,P<0.05)。糖尿病病程≥10年者与<5年者相比,DLCO/VA明显下降。2型糖尿病患者微血管病变积分为≥2者与微血管病变积分<2者相比,DLCO/VA明显下降。【结论】2型糖尿病患者肺弥散功能受损,肺脏可能也是糖尿病慢性病变的靶器官之一。

Objective] To evaluate the pulmonary ventilation function and diffusion capacity in the patients with type 2 diabetes mellitus to identify whether the lung is a target organ of chronic pathologic changes in diabetes mellitus. [Methods] Pulmonary ventilation function and diffusion capacity were investigated in 107 patients with type 2 diabetes mellitus and 61 healthy subjects. Glycosylated hemoglobin (HbA1c), urine albumin excretion rate (AER), fundus examination and nerve conduction velocity were included as parameters of glycemic control and diabetic microangiopathies. Diabetic patient got one point for each of the diabetic retinopathy, diabetic nephropathy and diabetic peripheral neuropathy. Microangiopathy score represented the total point. [Results] Pulmonary ventilation function was similar in the type 2 diabetic group and the control group. Compared with the control group, Carbon monoxide diffusion capacity (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were significantly lower in the type 2 diabetic group (P< 0.05). DLCO and DLCO/VA were inversely correlated with microangiopathy score (r: -0.291, -0.324, respectively, P< 0.01). Furthermore, DLCO/VA was inversely correlated with age and duration of diabetes mellitus (r: -0.269, -0.236, respectively, P< 0.05). Compared with diabetic patients with duration of less than 5 years, DLCO/VA was significantly decreased in patients with duration of more than 10 years. DLCO/VA was significantly decreased in diabetic patients with microangiopathy score of 2 or more, when compared with diabetic patients with microangiopathy score of less than 2. [Conclusion] The diffusion capacity in patients with type 2 diabetes mellitus was impaired. It suggests that the lung may also be the target organ of the chronic pathologic changes of diabetes mellitus.