慢性阻塞性肺病急性加重期血糖的变化与预后

The Change of Blood Glucose and the Prognosis in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨血糖在慢性阻塞性肺部疾病(COPD)中的检测价值。方法选取80例COPD患者为研究对象,按照不同的进展阶段分为急性加重期和稳定期,另选取40例健康体检者为对照组,比较COPD组和对照组的血糖水平。对COPD合并高血糖的患者进行强化血糖治疗,总结预后。结果 COPD急性加重期组的空腹血糖(FBG)、餐后2 h血糖(P2hBG)和糖化血红蛋白(HbA1c)均显著高于COPD稳定组和对照组(P<0.05)。强化血糖治疗后,患者的PH值、氧气分压(PO2)显著升高,二氧化碳分压(PCO2)显著降低(P<0.05)。结论 COPD加重期患者可能存在胰岛素抵抗,血糖升高,不利于预后,强化血糖治疗可提高疗效。

Objective To investigate the detection value of the blood glucose in patients with chronic obstructive pulmonary dis- ease （COPD）. Methods 80 cases of COPD patients were chosen as the research objects and they were divided into acute exacerba- tion and stable stage according to the different stages of progress. 40 healthy subjects were served as the control group. The blood glucose was compared between the COPD group and the control group. COPD patients with high blood glucose were given inten- sive glycemic treatment, and the prognosis was summarized. Results Fasting blood glucose （FBG）, 2h postprandial plasma glucose （P2hBG） and glycosylated hemoglobin （HbAlc） in COPD acute exacerbation group were significantly higher than those in COPD stable group and the control group （P〈0.05）. PH and the partial pressure of oxygen （PO2） significantly increased, the partial pres- sure of carbon dioxide （PCO2） significantly decreased after intensive glyeemic treatment in COPD patients with high blood glucose （P〈0.05）. Conclusion COPD acute exacerbation patients may have insulin resistance, elevated blood glucose is not conducive to the prognosis, intensive glycemic treatment can improve the efficacy of treatment.