COPD慢性呼吸衰竭合并2型糖尿病胰岛素抵抗患者无创通气治疗的临床研究

Clinical Study of Non-invasive Ventilation in Patients with COPD Chronic Respiratory Failure Complicated with Insulin Resistance Type 2 Diabetes

目的观察2型糖尿病患者发生因慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)所致慢性呼吸衰竭时应用无创通气治疗的效果。方法选取2021年8月—2022年8月期间在乌兰察布市中心医院接受治疗的210例COPD慢性呼吸衰竭合并2型糖尿病胰岛素抵抗患者为研究对象,采用信封法分为比照组(无创通气辅助治疗+常规降糖治疗)、研究组(无创通气辅助治疗+胰岛素治疗),各105例,比较两组的临床疗效、空腹血糖及胰岛素抵抗指数、血气分析。结果研究组临床治疗总有效率(94.29%)、PaO_(2)(60.22±5.21)mmol/L显著高于比照组的85.71%、(50.66±2.78)mmol/L,差异有统计学意义(P<0.05)。研究组空腹血糖值、胰岛素抵抗指数、二氧化碳分压(PaCO_(2))均低于比照组,差异有统计学意义(P<0.05)。结论COPD慢性呼吸衰竭合并2型糖尿病胰岛素抵抗患者治疗中应用无创通气,可以有效纠正胰岛素抵抗,患者血气指标、空腹血糖及胰岛素抵抗指数均有所改善,临床治疗效果显著。

Objective To observe the effect of non-invasive ventilation on chronic respiratory failure caused by chronic obstructive pulmonary disease(COPD)in patients with type 2 diabetes.Methods A total of 210 patients with COPD chronic respiratory failure combined with insulin resistance of type 2 diabetes who received treatment in Ulanqab Central Hospital from August 2021 to August 2022 were selected as the research objects.They were divided into comparison group(non-invasive ventilation assisted therapy+conventional hypoglycemic therapy)and study group(non-invasive ventilation assisted therapy+insulin therapy)by envelope method.The clinical efficacy,fasting blood glucose and insulin resistance index,blood gas analysis of the two groups were compared.Results The total effective rate was 94.29%and PaO_(2)(60.22±5.21)mmol/L in the study group were significantly higher than those in the comparison group 85.71%,(50.66±2.78)mmol/L,and the differences were statistically significant(P<0.05).Fasting blood glucose,insulin resistance index and partial pressure of carbon dioxide(PaCO_(2))in the study group were lower than those in the comparison group,and the differences were statistically significant(P<0.05).Conclusion The application of non-invasive ventilation in the treatment of patients with COPD chronic respiratory failure complicated with insulin resistance of type 2 diabetes can effectively correct insulin resistance,and the blood gas index,fasting blood glucose and insulin resistance index of patients are improved,and the clinical therapeutic effect is significant.