2型糖尿病患者肺功能改变及其相关因素研究

Study on the changes and correlation factors of pulmonary function in patients with type 2 diabetes

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68例2型糖尿病患者和60例正常对照组的肺功能,同时对糖尿病组肺功能变化进行多因素回归分析。结果病程>10年2型糖尿病组肺活量(VC)、1秒钟用力呼气容积(FEV1.0)、最大通气量(MVV)肺总量(TLC)、肺一氧化碳弥散量(DLCO)均明显低于对照组,差异均有统计学意义(t分别=3.52、4.57、5.06、4.98、5.13,P均<0.05);与病程<10年2型糖尿病组比较,差异也有统计学意义(t分别=3.65、5.34、6.28、6.98、4.87,P均<0.05);多因素线性回归分析VC、MVV、TLC与病程,糖化血红蛋白(HbA1C)、并发症积分、胰岛素低抗指数(HOMA-IR)、身高体重指数(BMI)无显著相关,FEV1.0与并发症积分呈显著相关(t=3.17,P<0.05),DLCO与HBA1C、HOMA-IR及并发症积分呈显著相关(t分别=3.43、2.95、5.08,P均<0.05)。结论2型糖尿病患者存在肺通气及肺弥散功能障碍,控制血糖改善胰岛素抵抗是其防治重点。

Objective To explore the changes of pulmonary function in type 2 diabetes and to investigate its related factors. Methods The pulmonary function of 68 patients with type 2 diabetes and 60 healthy objects were measured. The related factors of type 2 diabetes were analyzed with linear regression analysis. Results Vital capacity（vc）,forced expiratory volume in first second（FEV1）,maximal voluntary ventilation（MVV）,total lung capacity （TLC） and diffusion capacity for carbon monoxide of lung（DLCO） in diabetics with duration of more than 10 years had significant difference compared with that of the control group （t=3.52,4.57,5.06,4.98,5.13, P〈0.05）; and had significant difference compared with that of the diabetics with duration of less than 10 years （t=3.65,5.34,6.28,6.98, 4.87,P〈0.05）. Linear regression analysis showed that FEV1 was correlated with complication integra （t=3.17, P〈0.05）, while DLCO was correlated with HbAlc and HOMA-IR and complication integra （t=3.34,2.95,5.08, P〈0.05）. Conclusions Type 2 diabetes patients have abnormalities of pulmonary ventilatory function and diffusive function. Glycemic control and ameliorating insulin resistance are important for the prevention and cure.