糖尿病前期及糖尿病与特发性肺纤维化患者肺功能的关系研究

Relationship between Pre-diabetes,Diabetes and Pulmonary Function in Patients with Idiopathic Pulmonary Fibrosis

目的探讨糖尿病前期及糖尿病与特发性肺纤维化(IPF)患者肺功能的关系。方法查阅徐州市中医院2016年1月—2018年7月住院病历资料并选取70例IPF患者作为IPF组,其中无糖尿病43例,糖尿病前期7例,糖尿病20例;按照年龄、性别1:1匹配原则选取2018年4—7月徐州市中医院体检中心健康体检者70例作为对照组。比较两组受试者肺通气功能指标[包括第1秒用力呼气容积占预计值百分比(FEV_1%pred)、用力肺活量占预计值百分比(FVC%pred)]、肺弥散功能指标[包括一氧化碳弥散量占预计值百分比(DLCO%pred)、脉搏氧饱和度(SpO_2)]、糖尿病前期或糖尿病者所占比例,并比较有无糖尿病IPF患者肺通气功能指标、肺弥散功能指标及糖皮质激素使用率。结果 (1)IPF组患者FEV_1%pred、FVC%pred、DLCO%pred及SpO_2低于对照组,糖尿病前期或糖尿病者所占比例高于对照组(P<0.05)。(2)无糖尿病、糖尿病前期及糖尿病者FEV_1%pred、FVC%pred及糖皮质激素使用率比较,差异无统计学意义(P>0.05);糖尿病前期及糖尿病者DLCO%pred及SpO_2低于无糖尿病者(P<0.05);糖尿病前期与糖尿病者DLCO%pred及SpO_2比较,差异无统计学意义(P>0.05)。(3)Spearman秩相关分析结果显示,血糖与IPF患者DLCO%pred(r_s=-0.509)、SpO_2(r_s=-0.287)呈负相关(P<0.05)。结论 IPF并糖尿病前期或糖尿病患者肺弥散功能下降,且血糖与IPF患者肺弥散功能有关。

Objective To investigate the relationship between pre-diabetes,diabetes and pulmonary function in patients with idiopathic pulmonary fibrosis.Methods Medical records were looked up to select 70 patients with idiopathic pulmonary fibrosis as IPF group in Xuzhou Traditional Chinese Medicine Hospital from January 2016 to July 2018,including 43 patients without diabetes,7 patients with pre-diabetes and 20 patients with diabetes;a total of 70 healthy volunteers were selected as control group according to 1:1 matching principle based on age and gender at the same time.Index of pulmonary ventilation function(including FEV1%pred and FVC%pred)and pulmonary diffusion function(including DLCO%pred and SpO2),proportion of patients with pre-diabetes or diabetes were compared between the two groups,meanwhile index of pulmonary ventilation function and pulmonary diffusion function,and utilization rate of glucocorticoids were compared in patients with diabetes or not.Results(1)FEV1%pred,FVC%pred,DLCO%pred and SpO2 in IPF group were statistically significantly lower than those in control group,while proportion of patients with pre-diabetes or diabetes in IPF group was statistically significantly higher than that in control group,respectively(P<0.05).(2)No statistically significant differences of FEV1%pred,FVC%pred or utilization rate of glucocorticoids was found in patients without diabetes,with pre-diabetes or diabetes(P>0.05);DLCO%pred and SpO2 in patients with pre-diabetes or diabetes were statistically significantly lower than those in patients without diabetes(P<0.05),while no statistically significant differences of DLCO%pred or SpO2 was found in patients with pre-diabetes or diabetes(P>0.05).(3)Spearman rank correlation analysis results showed that,blood glucose was negatively correlated with DLCO%pred(rs=-0.509)and SpO2(rs=-0.287)in patients with idiopathic pulmonary fibrosis,respectively(P<0.05).Conclusion Pulmonary diffusion function decreases in idiopathic pulmonary fibrosis patients merged with pre-diabetes or diabetes,and blood glucose was significantly correlated with the pulmonary diffusion function.