支气管哮喘急性期胰岛素抵抗对肺功能和心肌酶的影响

Effects of Insulin Resistance on Pulmonary Function and Myocardial Enzymes in the Acute Stage of Bronchial Asthma

目的:探讨支气管哮喘急性期胰岛素抵抗对肺功能和心肌酶的影响。方法:选取2019年1月-2019年12月期间江苏大学附属医院儿科哮喘门诊就诊的支气管哮喘急性期患儿60例为病例组,同期健康儿童60例为对照组,计算胰岛素抵抗指数(HOMA-IR)。病例组根据HOMA-IR正常值进一步将其分为胰岛素抵抗组32例(HOMA-IR>1.0),非胰岛素抵抗组28例(HOMA-IR≤1.0)。病例组患儿行肺功能检查用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、呼气峰流速(PEF),测定心肌酶,包括乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB),比较不同HOMA-IR的支气管哮喘患儿肺功能、心肌酶的差异性。结果:病例组HOMA-IR、血糖(FBG)、血清胰岛素(FINS)水平均高于正常对照组,差异有统计学意义(P<0.05)。胰岛素抵抗组FVC、FEV1、PEF均低于非胰岛素抵抗组,差异有统计学意义(P<0.05)。胰岛素抵抗组心肌酶LDH、CK、CK-MB均高于非胰岛素抵抗组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,HOMA-IR与FVC、FEV1、PEF呈负相关(分别r=-0.536,-0.542,-0.605,P<0.05),与LDH、CK、CK-MB呈正相关(分别r=0.474,0.588,0.693,P<0.05)。结论:支气管哮喘患儿急性期胰岛素抵抗明显,急性期胰岛素抵抗可以降低肺功能,导致心肌受损。胰岛素抵抗的干预治疗可能为支气管哮喘的治疗提供新的思路。

Objective: To explore the effects of insulin resistance on pulmonary function and myocardial enzymes in the acute sage of bronchial asthma. Methods: 60 children with bronchial asthma in the acute stage who visited the hospital form January2019 to December 2019 were selected as the case group, and 60 health children during the same period were selected as the control group. According to the normal value of HOMA-IR, 32 cases of the case group was further divided into insulin resistance group(HOMA-IR>1.0) and 28 cases into non-insulin resistance group(HOMA-IR≤1.0). To compare the differences with HOMAIR in lung function and cardiac enzymes in children with bronchial asthma, the children in the case group underwent pulmonary function examination including forced vital capacity(FVC), forced expiratory volume in the first second(FEV1), expiratory peak flow rate(PEV), and myocardial enzymes were measured, including lactate Dehydrogenase(LDH), creatine kinase(CK) and creatine isoenzyme(CK-MB). Results: The HOMA-IR,FBG and FINS in the case group were higher than those in the control group, with statistically significant differences(P<0.05). FVC, FEV1 and PEF in the insulin resistance group were lower than those in the noninsulin resistance group, with statistically significant differences(P<0.05). The myocardial enzymes LDH, CK and CK-MB in the insulin resistance group were higher than those in the non-insulin resistance group, with statistically significant differences(P<0.05). Pearson correlation analysis results showed that the HOMA-IR was negatively correlated with FVC, FEV1 and PEF(r=-0.536,-0.542,-0.605,respectively, P<0.05), positively correlated with LDH, CK and CK-MB(r=0.474, 0.588, 0.693, respectively, P<0.05). Conclusion: Children with bronchial asthma have obvious insulin resistance in the acute stage, which can reduce pulmonary function and lead to myocardial damage. The intervention of insulin resistance may provide new ideas for the treatment of bronchial asthma.