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目的探讨慢性阻塞性肺疾病(COPD)与胰岛素抵抗(IR)的相关性。方法选择330例COPD患者,根据《慢性阻塞性肺疾病诊治指南》(2007年修订版)分为:轻度COPD组95例,中度COPD组95例,重度COPD组75例,极重度COPD组65例,并设正常对照组40例。取新鲜标本以全自动生化分析仪测定所有对象的空腹血糖、胰岛素、血脂,免疫比浊法测定尿白蛋白排泄率,电发光测定法测定胰岛素敏感指数(ISI)等指标。结果与正常对照组相比,各COPD组空腹血糖、血脂、尿白蛋白排泄率均显著升高,ISI显著降低(P均<0.05)。与轻、中度COPD组相比,重度、极重度COPD组空腹血糖、血脂、尿白蛋白排泄率显著升高,ISI显著降低(P均<0.05)。结论慢性阻塞性肺疾病的患者存在胰岛素抵抗,并随疾病程度的加重,胰岛素敏感性降低。
Objective To investigate the relationship between chronic obstructive pulmonary disease (COPD) and insulin resistance (IR). Methods A total of 330 patients with COPD were selected and divided into 95 cases of mild COPD, 95 cases of moderate COPD, 75 cases of severe COPD and very severe COPD according to the Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Diseases (2007 Revision) 65 cases, and the normal control group of 40 cases. Fasting blood glucose, insulin, blood lipids, urinary albumin excretion rate were measured by immunoturbidimetry and insulin sensitivity index (ISI) were measured by automatic biochemical analyzer. Results Compared with the normal control group, the fasting blood glucose, blood lipid and urinary albumin excretion rate were significantly increased and the ISI was significantly decreased in all COPD groups (all P <0.05). Compared with mild and moderate COPD group, fasting blood glucose, blood lipid and urinary albumin excretion rate and ISI in severe and severe COPD group were significantly decreased (all P <0.05). Conclusion Patients with chronic obstructive pulmonary disease have insulin resistance. With the severity of the disease, insulin sensitivity decreases.