慢性阻塞性肺疾病急性发作期的糖代谢改变

Changes of glucose metabolism in patients with chronic obstructive pulmonary disease during acute exacerbation.

目的 :探讨慢性阻塞性肺疾病 (COPD)患者急性发作期的糖代谢改变。方法 :采用口服葡萄糖耐量试验 ,胰岛素释放试验检测26例COPD急性发作期患者血糖及胰岛素水平。结果 :中重度低氧血症患者空腹血糖及血浆胰岛素水平明显增高 ,胰岛素敏感指数明显下降 ,与轻度低氧血症患者相比差异有显著性 (P<0 001 ,P<0 05,P<0 001) ,血糖与PaO2 呈显著负相关(r= -0.5242,P<0 05) ;中重度低氧血症患者各时点血糖水平较轻度低氧血症患者显著性增高 (P<0 05) ;胰岛素释放试验两组差异无显著性。但两组胰岛素释放时间均明显延长。结论 :COPD急性发作期合并低氧血症患者存在糖耐量减低。

Objective:To study the changes of glucose metabolism in patients with chronic obstructive pulmonary disease(COPD) during acute exacerbation.Methods:The plasma glucose and insulin level of 26 patients with COPD during acute exacerbation were measured with oral glucose tolerance test(OGTT)and insulin release test(IRT).Results:Compared with the moderat hypoxemia group,the level of empty stomach plasma glucose and insulin in the intermediate and severe hypoxemia groups were significantly higher and the index of insulin sensitvity was significantly decreased,and the difference was remarkable(P<0.001,P<0.05),There was a marked negative correlation between the level of plasma glucose and PaO2(r=-0.5242,P<0 05).The level of plasma glucose in the intermediate and severe hypoxemia groups before an after oral glucose load were higher than that in the moderate hypoxemia group(P<0.05).There was no significant difference in insulin release test between the two groups(P>0.05),but the time of insulin release was delayed in two groups.Conclusion:There is a decrement of glucose tolerance in patients with COPD during acute exacerbation with hypoxemia.