CAJ | 학술논문

目的探讨老年2型糖尿病患者血糖水平对肺弥散功能的影响及临床意义.方法选取老年2型糖尿病患者132例,根据血糖水平分成控制理想组(控制理想组)57例与血糖控制不佳组(未控制组)75例,同时选取无糖尿病年龄匹配52例健康体检者为对照组.测量糖尿病患者的空腹血糖、餐后2h血糖、糖化血红蛋白(HbA1c)及空腹胰岛素,计算稳态模型胰岛素抵抗指数(HOMA-IR).两组糖尿病患者进行尿白蛋白排泄率检测、眼底检查及神经传导速度检查.所有研究对象均检测肺通气、肺一氧化碳弥散量(DLCO)和单位肺泡容积DLCO(DLCO/VA).结果未控制组的空腹血糖、餐后2h血糖、HbA1c及HOMA-IR均高于理想组(均P＜0.05).两组糖尿病患者与对照组比较,控制理想组和未控制组的体质指数均高于对照组(P＜0.05),肺通气功能差异无统计学意义(P＞0.05).两组糖尿病患者的DLCO和DLCO/VA低于对照组(均P＜0.05),未控制组DLCO和DLCO/VA低于控制理想组(均P＜0.05).微血管病变积分2分及以上者的DLCO和DLCO/VA低于无微血管病变者(P＜0.05).多元线性回归分析,DLCO、DLCO/VA与HbA1c、HOMA-IR、糖尿病病程及微血管病变积分呈负相关(r值分别为-2.51、-2.35、-2.42、-2.37、-2.41、-2.52、-2.47、-2.36,均P＜0.05).结论老年2型糖尿病患者存在肺弥散功能障碍,血糖水平越高,肺弥散功能越差,肺脏可能是糖尿病靶器官损害之一.
목적 탐토노년2형당뇨병환자혈당수평대폐미산공능적영향급림상의의.방법 선취노년2형당뇨병환자132례,근거혈당수평분성공제이상조(공제이상조)57례여혈당공제불가조(미공제조)75례,동시선취무당뇨병년령필배52례건강체검자위대조조.측량당뇨병환자적공복혈당、찬후2h혈당、당화혈홍단백(HbA1c)급공복이도소,계산은태모형이도소저항지수(HOMA-IR).량조당뇨병환자진행뇨백단백배설솔검측、안저검사급신경전도속도검사.소유연구대상균검측폐통기、폐일양화탄미산량(DLCO)화단위폐포용적DLCO(DLCO/VA).결과 미공제조적공복혈당、찬후2h혈당、HbA1c급HOMA-IR균고우이상조(균P＜0.05).량조당뇨병환자여대조조비교,공제이상조화미공제조적체질지수균고우대조조(P＜0.05),폐통기공능차이무통계학의의(P＞0.05).량조당뇨병환자적DLCO화DLCO/VA저우대조조(균P＜0.05),미공제조DLCO화DLCO/VA저우공제이상조(균P＜0.05).미혈관병변적분2분급이상자적DLCO화DLCO/VA저우무미혈관병변자(P＜0.05).다원선성회귀분석,DLCO、DLCO/VA여HbA1c、HOMA-IR、당뇨병병정급미혈관병변적분정부상관(r치분별위-2.51、-2.35、-2.42、-2.37、-2.41、-2.52、-2.47、-2.36,균P＜0.05).결론 노년2형당뇨병환자존재폐미산공능장애,혈당수평월고,폐미산공능월차,폐장가능시당뇨병파기관손해지일.
Objective To investigate the effect of blood glucose level on pulmonary diffusion capacity in elderly patients with type 2 diabetes and its clinical significance.Methods Totally 132 older adults with type 2 diabetes were enrolled in this study.According to blood glucose level,the patients were divided into well-controlled group (n =57) and poor controlled group (n =75).Additionally,52 age-matched non-diabetic healthy subjects were selected as control group.Levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) and 2-hour postprandial glucose (2h PG) in the diabetic patients were detected,and homeostasis model assessment of insulin resistance (HOMA IR) was calculated.The patients with type 2 diabetes underwent urinary albumin excretion rate (UAER) detection,fundus examination and nerve conduction velocity test.pulmonary ventilation,diffusion of the lungs for carbon monoxide (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were examined in all subjects.Results Levels of FBG,2h PG,HbA1c and HOMA-IR were higher in poor-controlled group than in good glycemicwell-controlled group (all P＜0.05).Compared with the control group,body mass index (BMI) was increased in diabetic groups (both P＜0.05).The pulmonary ventilation function in the three groups had no significant differences (P＞0.05).DLCO and DLCO/VA were lower in diabetic groups than in the control group(all P＜0.05).DLCO and DLCO/VA in poor-controlled group were lower than those in well controlled group (both P＜0.05).DLCO and DLCO/VA were lower in patients with microangiopathy score ≥ 2 than those without microangiopathy (both P ＜ 0.05).Multiple liner regression analysis showed that DCLO and DLCO/VA were negatively correlated with HbA1c,HOMA-IR,duration of diabetes and microangiopathy (r=-2.51,-2.35,-2.42,-2.37,-2.41,-2.52,-2.47,-2.36,all P＜0.05).Conclusions The pulmonary diffusion capacity is significantly impaired in elderly patients with type 2 diabetes.Pulmonary diffusion capacity is negatively correlated with the blood glucose level.The lung may be one of the target organs of type 2 diabetes mellitus.