糖尿病合并肺结核患者营养状况与肺功能的相关性研究

Study on the Correlation between Nutritional Status and Pulmonary Function in Diabetic Patients with Pulmonary Tuberculosis

目的:探讨糖尿病合并肺结核患者的营养状况对肺功能的影响,以为临床工作提供参考。方法:随机选取2018年1月-2019年5月在笔者所在医院住院的137例糖尿病合并肺结核患者,入选患者分别测量体质量指数(BMI)、上臂围(MAC)和白蛋白(ALB)等营养指标及肺功能。根据身体质量指数(BMI)值分为A1组(≥18.5 kg/m^2)和A2组(<18.5 kg/m^2);按上臂围(MAC)值分为B1组(≥24 cm)和B2组(<24 cm);按白蛋白(ALB)值分为C1组(≥35 g/L)和C2组(<35 g/L),分别比较各组肺功能指标,并对BMI、MAC、ALB与肺功能各项指标进行相关性研究。结果:A2组FEV1%低于A1组,RV高于A1组,差异均有统计学意义(P<0.05),两组FVC%、FEV1/FVC%、MVV%比较差异无统计学意义(P>0.05);B2组FEV1%低于B1组,RV高于B1组,差异均有统计学意义(P<0.05),两组FVC%、FEV1/FVC%、MVV%比较差异无统计学意义(P>0.05);C2组FEV1%低于C1组,RV高于C1组,差异均有统计学意义(P<0.05),两组FVC%、FEV1/FVC%、MVV%比较差异无统计学意义(P>0.05)。BMI与FVC%、FEV1%呈正相关(r=0.291、0.477,P=0.001,0.000),与RV呈负相关(r=-0.299,P=0.012);MAC与FVC%、FEV1%、MVV%呈正相关(r=0.302、0.456、0.245,P=0.000、0.000、0.004),与RV呈负相关(r=-0.280,P=0.001);ALB与FVC%、FEV1%、MVV%呈正相关(r=0.266、0.432、0.261,P=0.002、0.000、0.002),与RV呈负相关(r=-0.314,P=0.000)。结论:糖尿病合并肺结核患者的营养状态与肺功能密切相关,营养不良会影响肺功能,改善患者的营养状况有助于提高患者呼吸功能指数及预后。

Objective:To explore the influence of nutritional status on pulmonary function in patients with diabetes mellitus complicated with tuberculosis,so as to provide reference for clinical work.Method:A total of 137 patients with diabetes mellitus and tuberculosis who were hospitalized in my hospital from January 2018 to May 2019 were randomly selected.They were investigated by body mass index(BMI),upper arm circumference(MAC)and albumin(ALB)and assessed by lung function.They were divided into A1 group(≥18.5 kg/m^2)and A2 group(<18.5 kg/m^2)according to BMI value,B1 group(≥24 cm)and B2 group(<24 cm)according to MAC,C1 group(≥35 g/L)and C2 group(<35 g/L)according to ALB value.The differences of pulmonary function indices were compared among each group,and the correlation between BMI,MAC,ALB and pulmonary function indices was analyzed.Result:The FEV1%of A2 group was lower than that of A1 group,the RV was higher than that of A1 group(P<0.05),there was no significant difference in FVC%,FEV1/FVC%,MVV%between the two groups(P>0.05).The FEV1%of B2 group was lower than that of B1 group,the RV was higher than that of B1 group(P<0.05),there was no significant difference in FVC%,FEV1/FVC%,MVV%between the two groups(P>0.05).The FEV1%of C2 group was lower than that of C1 group,the RV was higher than that of C1 group(P<0.05),there was no significant difference in FVC%,FEV1/FVC%,MVV%between the two groups(P>0.05).BMI were positively correlated with FVC%,FEV1%(r=0.291,0.477,P=0.001,0.000),and was negatively correlated with RV(r=-0.299,P=0.012).MAC was positively correlated with FVC%,FEV1%and MVV%(r=0.302,0.456,0.245,P=0.000,0.000,0.004),and was negatively correlated with RV(r=-0.280,P=0.001).ALB was positively correlated with FVC%,FEV1%and MVV(r=0.266,0.432,0.261,P=0.002,0.000,0.002),and was negatively correlated with RV(r=-0.314,P=0.000).Conclusion:The nutritional status of diabetic patients with pulmonary tuberculosis is closely related to pulmonary function.Malnutrition will affect pulmonary function.Improving the nutritional status of patients will help to improve the respiratory function index and prognosis.