^(99m)Tc-DTPA气溶胶吸入法测定糖尿病患者肺上皮细胞通透性改变

Changes of Lung Epithelia Permeability in Diabetic Patients Examined by Technetium-99m-DTPA Scintigraphy

目的 探讨2型糖尿病患者肺泡通透性的变化。方法 采用吸入99mTcDTPA气溶胶后,测定肺脏清除半衰期的方法。选择2型糖尿病28例,1型糖尿病2例,伴有并发症的患者16例(A组),无并发症者14例(B组),20例健康志愿者作为对照组(C组)。结果 ①糖尿病患者肺脏对99mTcDTPA清除半衰期(T1/2)较正常人明显缩短,差别有显著性(P<0.05)。②A组糖尿病患者肺脏99mTcDTPA清除半衰期较B组糖尿病患者缩短,但统计学分析两组差别无显著性。本结果与以往采用此方法得出的结果相反,即糖尿病时肺泡清除99mTcDTPA加快。结论 我们认为,99mTcDTPA是水溶性物质,糖尿病时肺上皮细胞对水溶性物质清除加快,提示肺泡基底膜病变,表现为肺上皮细胞通透性增高,符合糖尿病的基本病理变化。

To study lung epithelial permeability in diabetic patients,the clearance of inhaled 99m Tc*.diethyl triaminepentaacetic acid(DTPA) aerosol from lungs was investigated using 99m Tc aerosol scintigraphy. Methods A total of 30 diabetic patients (14 female,16 male) aged of 20～74 years was selected.Twenty eight were type 2 diabetes,two were type 1 diabetes.Sixteen with complications (such as retinopathy or/and nephropathy) were taken as group A,and fourteen without any complications as group B.Twenty health nonsmokers were as a control group (Group C).Dynamic scintigrams were obtained following inhalation of 99m Tc*.DTPA thyough a radioaerosol de livery system.Time*.activity curves were obtained and half*.time ( T 1/2 ) of DTPA wae measured from the curves. Results The T 1/2 values (min± s ) in the right and left lung in diabetic patients were 65.64±21.84 and 66.51±22.24 respectively;In group C, T 1/2 values in the right and left lung were 83.27±30.17 and 86.47±33.28 respectively,The T 1/2 values in group A were significantly shorter than those in group C ( P <0.05) .The T 1/2 values in right and left lung in group A and group B were 61.48±23.46 and 60.23±22.69;and 70.75±18.37 and 74.23± 19.83 respectively.No significant difference was found between group A and group B ( P >0.05).The T 1/2 values in group A and group B were significantly shorter than those in group C ( P <0.05). Results The T 1/2 values (min± s ) in the right and left lung in diabetic patients were 65.64±21.84 and 66.51±22.24 respectively;In group C, T 1/2 values in the right and left lung were 83.27±30.17 and 86.47±33.28 respectively,The T 1/2 values in group A were significantly shorter than those in group C ( P <0.05) .The T 1/2 values in right and left lung in group A and group B were 61.48±23.46 and 60.23±22.69;and 70.75±18.37 and 74.23± 19.83 respectively.No significant difference was found between group A and group B ( P >0.05).The T 1/2 values in group A and group B were significantly shorter than those in group C ( P <0.05). Conclusions The present findings show that impaired lung epithelial permeability in diabetic patients is present,but does not support the previous results using the same method.The clearance of 99m Tc*.DTPA from the lung in diabetic patients was faster than that of the controls;in patients with complications it was faster than in those without complications.