2型糖尿病患者的肺弥散功能检测分析

摘要

目的:检测2型糖尿病患者的肺通气和弥散功能,探讨肺脏是否为糖尿病慢性病变的靶器官.方法: 对107名2型糖尿病患者行肺通气及弥散功能检测,并与61名年龄、性别匹配的健康者比较.糖尿病患者需行糖化血红蛋白(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.结果: 2型糖尿病组肺通气功能与正常对照组相比,无显著差异.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).此外,DLCO/VA还与年龄、病程呈负相关(r分别为-0.269、-0.236,P<0.05).结论: 2型糖尿病患者虽然肺通气功能基本正常,但有弥散功能受损,提示肺脏可能也是糖尿病慢性病变的靶器官之一.%AIM: To evaluate the pulmonary function in patients with type 2 diabetes mellitus in order to identify whether the lung is a target organ of chronic pathologic changes in diabetes mellitus. METHODS: Pulmonary ventilation function and diffusion capacity were studied in 107 patients with type 2 diabetes mellitus and 61 healthy subjects matched for age and sex. Glycosylated hemoglobin (HbA1c), urine albumin excretion rate (AER), fundus examination and nerve conduction velocity were included as parameters of glycemic control and diabetic microangiopathies. RESULTS: Pulmonary ventilation function was similar in type 2 diabetic group and the control. Compared with the control, carbon monoxide diffusion capacity (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were significantly lower in type 2 diabetic group (P<0.05). DLCO and DLCO/VA were inversely correlated with microangiopathy score (r: -0.291, -0.324, respectively, P<0.01). Furthermore, DLCO/VA was negatively correlated with age and duration of diabetes mellitus (r: -0.269, -0.236, respectively, P<0.05). CONCLUSIONS: Pulmonary ventilation function is normal in patients with type 2 diabetes mellitus, but their diffusion capacity is impaired. It suggests that the lung may also be the target organ of the chronic pathologic changes of diabetes mellitus.