论文部分内容阅读
目的探讨 2型糖尿病患者的肺功能变化及其与胰岛素抵抗和胰岛 β细胞分泌功能的关系。方法测定 60例 2型糖尿病患者 (糖尿病组 )和 3 5例健康对照组肺功能 ,并进行比较分析。对糖尿病组进行胰岛素释放试验 ( IRT) ,计算胰岛素敏感指数 ( ISI)和胰岛 β细胞分泌指数 ( MBCI) ,并对相关因素进行分析。结果糖尿病组的总肺活量 ,用力肺活量 ,肺活量 1秒量 ,70 %～ 80 %肺活量阶段内平均呼气流量 ( V 2 5 ) ,肺一氧化碳弥散量 ( DL CO)均明显低于对照组 ( P<0 .0 5或 P<0 .0 1)。多元线性分析表明 ,V 2 5、DLCO与空腹血糖( FPG)、空腹胰岛素 ( FINS)及微血管并发症积分呈负相关 ( P<0 .0 5 ) ,与 ISI呈正相关 ( P<0 .0 5 ) ,而与 MBCI无关。结论 2型糖尿病患者存在以限制性为主的肺通气功能障碍和小气道阻塞以及弥散功能障碍。 FPG、FINS、胰岛素抵抗及微血管病变程度等可能是影响肺功能的主要因素 ,而与胰岛β细胞分泌功能无关。
Objective To investigate the changes of pulmonary function in type 2 diabetic patients and its relationship with insulin resistance and pancreatic β-cell secretion. Methods The lung function of 60 patients with type 2 diabetes mellitus (DM) and 35 healthy controls were measured and compared. Insulin release test (IRT), insulin sensitivity index (ISI) and pancreatic β-cell secretion index (MBCI) were calculated in the diabetic group, and the related factors were analyzed. Results The total vital capacity, forced vital capacity and vital capacity of diabetic group were significantly lower than those of control group (V 2 5, DL CO) in 70% ~ 80% 0 .0 5 or P <0 .0 1). Multivariate linear analysis showed that V 2 5, DLCO had negative correlation with fasting plasma glucose (FPG), fasting insulin (FINS) and microvascular complications (P <0.05), and was positively correlated with ISI (P <0.05 ), But nothing to do with MBCI. Conclusions Patients with type 2 diabetes have restrictive pulmonary ventilatory dysfunction and small airway obstruction as well as diffuse dysfunction. FPG, FINS, insulin resistance and the degree of microvascular disease may be the main factors affecting lung function, and has nothing to do with the secretion of pancreatic β-cell function.