【作者】 张丽；

【导师】 王敏哲；

【作者基本信息】 新疆医科大学 ， 内科学， 2010， 硕士

【摘要】 目的:探讨2型糖尿病患者肺功能变化及其相关因素。方法:用肺功能指标测定入选74例2型糖尿病患者(糖尿病组)的肺功能并同时测定甘油三脂、胆固醇、C反应蛋白、同型半胱氨酸、脂蛋白a、空腹血糖、空腹胰岛素、糖化血红蛋白(HbA1c)检查以及尿蛋白排泄率(AER)检测、眼底检查以及神经传导速度检查,计算胰岛素抵抗指数;74例无糖尿病患者为对照组完成9个月的观察,比较两组肺功能变化,并对糖尿病组肺功能变化的相关因素进行多因素线性回归分析。结果:糖尿病组肺活量(VC)、1s用力呼气容积(FEV1)、肺总量(TLC)、最大自主通气量(MVV)、肺一氧化碳弥散量(DLCO)、肺单位体积一氧化碳弥散量(KCO)均明显低于对照组(P<0.05)。对糖尿病组进行线性相关分析表明,VC、FEV1、TLC均与HbA1c呈负相关(P<0.01),且VC与同型半胱氨酸呈负相关(P<0.05), MVV与微血管并发症积分呈相关性(P<0.01)。DLCO、KCO均与HbA1c、微血管并发症积分呈负相关(P<0.05),DLCO亦与胰岛素抵抗指数呈负相关(P<0.05),并对糖尿病患者肺功能指标与多种相关因素进行多因素线性回归分析。结论:2型糖尿病患者存在肺通气功能及弥散功能减退,肺脏可能是糖尿病慢性病变的靶器官之一,控制血糖、改善胰岛素抵抗、抗氧化应激治疗是其防治重点。更多还原

【Abstract】 Objective:To investigate the changes of pulmonary function in patients with type 2 diabetes and its related factors. Methods: 74 cases with type 2 diabetes patients(diabetes group) were selected according to pulmonary function test .Triglyceride, total cholesterol, C-reactive protein, homocysteine, lipoprotein-a, glycosylated hemoglobin (HbA1c), urine albumin excretion rate(AER),fundus examination and nerve conduction velocity, insulin resistance index were detected in 74 patients with type 2 diabetes.All cases were observed in nine months while 74 cases of nondiabetic as control subjects,two groups’pulmonary function were compared,related factors of type 2 diabetes were analyzed by multiple linear regression analysis.Results:Compared with the control group, vital capacity(VC),forced expiratory volume in first second(FEV1),total lung capacity(TLC),maximal voluntary ventilation(MVV),diffusion capacity for carbonmonoxide of lung(DLCO)and diffusion capacity for carbon monoxide per liter of alveolar volume(KCO)were significantly decrease in the type 2 diabetic group(P<0.05).Liner regression analysis showed that VC、FEV1、TLC、DLCO、KCO were negative correlated with HbA1c,VC was negative correlated with homocysteine.(P<0.05),maximal voluntary ventilation(MVV)、DLCO、KCO were negative correlated with complication integra(P<0.05).DLCO was negative correlated with insulin resistance index(P<0.05). Conclusion:The patients of type 2 diabetes exist abnormal pulmonary ventilatory function and diffusive function,which imply that the lung might be the target organ in the chronic pathologic changes of diabetes.Glycemic control,ameliorating insulin tesistance and anti-oxidative stress therapy are the emphasis of the prevention and therapy .更多还原