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【目的】检测2型糖尿病患者的肺通气和弥散功能,探讨肺是否为糖尿病慢性病变的靶器官。【方法】检测107名2型糖尿病患者行肺通气及弥散功能,与61名健康者相比较。糖尿病患者行糖化血红蛋白(HbA1c)、尿白蛋白排泄率(AER)检测、眼底检查以及神经传导速度检查,以评价血糖控制水平以及糖尿病微血管病变状况。具有糖尿病视网膜病变、糖尿病肾病、糖尿病周围神经病变者各记1分,总分以微血管病变积分表示。【结果】2型糖尿病组肺通气功能与正常对照组相比,差异无统计学意义。2型糖尿病组一氧化碳弥散量(DLCO)及单位肺泡容积的一氧化碳弥散量(DLCO/VA)较对照组明显降低(P<0.05)。DLCO、DLCO/VA与微血管病变积分呈负相关(r分别为-0.291、-0.324,P<0.01)。DLCO/VA与年龄、病程呈负相关(r分别为-0.269、-0.236,P<0.05)。糖尿病病程≥10年者与<5年者相比,DLCO/VA明显下降。2型糖尿病患者微血管病变积分为≥2者与微血管病变积分<2者相比,DLCO/VA明显下降。【结论】2型糖尿病患者肺弥散功能受损,肺脏可能也是糖尿病慢性病变的靶器官之一。
【Objective】 The purpose of this study was to examine the pulmonary ventilation and diffuse function in patients with type 2 diabetes mellitus (T2DM) and to explore whether the lungs are the target organ of chronic diabetic diseases. 【Methods】 One hundred and seven patients with type 2 diabetes mellitus underwent pulmonary ventilation and diffusion function, compared with 61 healthy controls. Diabetic patients underwent HbA1c, urinary albumin excretion rate (AER) examination, fundus examination and nerve conduction velocity test to evaluate the level of blood sugar control and diabetic microangiopathy. With diabetic retinopathy, diabetic nephropathy, diabetic peripheral neuropathy each recorded a score of 1, the total score to microvascular disease score. 【Results】 There was no significant difference in lung ventilation between type 2 diabetes mellitus group and normal control group. Compared with the control group, the DLCO and the alveolar volume diffused volume of carbon monoxide (DLCO / VA) in type 2 diabetes group were significantly lower than those in control group (P <0.05). DLCO and DLCO / VA were negatively correlated with microvessel density (r = -0.291, -0.324, P <0.01, respectively). DLCO / VA was negatively correlated with age and duration (r = -0.269, -0.236, P <0.05, respectively). Dlco / VA decreased significantly in patients with diabetes> 10 years and <5 years. Type 2 diabetic patients with microvascular disease score ≥ 2 and microvascular disease score <2, DLCO / VA decreased significantly. 【Conclusion】 Patients with type 2 diabetes have impaired lung diffusion and the lungs may also be one of the target organs for chronic diabetic diseases.