2型糖尿病患者肺功能改变的研究

Study the changes of pulmonary function in patients with type 2 diabetes

目的检测2型糖尿病(DM)患者肺功能,探讨肺是否为DM病变的靶器官。方法检测200例2型DM患者和60例健康者肺通气、弥散功能及糖化血红蛋白,并进行比较,对60例有并发症的DM患者给予胰岛素强化治疗4周后再次检测,以了解治疗前、后肺功能变化。结果 2型DM组肺通气、弥散功能均较正常对照组明显降低(P<0.05),微血管病变积分大于或等于2分者最大通气量(MVV)、用力肺活量(FVC)、1s用力呼气量(FEV1)、单次呼吸肺一氧化碳转移因子(TLCOSB)、肺一氧化碳转移因子/肺泡容量(TLCO/VA)较微血管病变积分小于2分者明显降低。治疗后患者FVC、FEV1、TLCOSB、TLCO/VA及糖化血红蛋白较治疗前有所好转。结论 2型DM患者肺功能受损,肺脏是DM病变的靶器官之一。控制血糖是防治肺功能损害的重要措施。

Objective To evaluate the pulmonary function in the patients with type 2 diabetes to identify whether the lung is a target organ of pathologic changes in diabetes. Methods Pulmonary function and glycosylated hemoglobin Alc（HBAlc） were in- vestigated in 200 patients with type 2 diabetes and 60 healthy subjects. 60 patients of type 2 diabetes with complications were given 4 weeks long intensive insulin therapy,pulmonary function and HBAlc were investigated again. Results The pulmonary ventilation function and diffusion capacity in type 2 diabetes group were lower than the control group（P〈0.05）, MVV, FVC, FEV1, TLCO SB,TLCO/VA were significantly diabetic in patients with microangiopathy score of two or more,when compared wiyh diabetic patients with microangiopathy score of less than two. After 4 weeks long intensive insulin therapy,TLCO SB, TLCO/VA and HBAlc decreased significantly. Conclusion The pulmonary function in patients with type 2 diabetes is impaired. It suggests that the lung may be the target organ of pathologic changes of diabetes. Glycemic control is important for the prevention and cure for pulmonary function impaired.