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背景:目前糖尿病的发病率有上升的趋势,有关糖尿病患者肺功能状况的报道较少。目的:对比观察糖尿病患者与正常人肺功能状况的差异,探讨糖尿病病程与肺功能改变之间的关系。设计:病例对比观察。单位:武汉大学人民医院。对象:选择2000-01/2003-12在武汉大学人民医院就诊的糖尿病患者90例,均自愿参加观察。胰岛素依赖型20例,非胰岛素依赖型70例。另外将90例患者以10年病程为界分为2组,病程小于10年组40例,病程大于10年组50例。选择肺功能正常人30例为健康对照组,均为积极参与本课题的志愿者。方法:分别测定各组观察对象的肺功能指标:肺活量、用力肺活量、第1秒用力呼气容积占用力肺活量比值、呼气流速峰值及最大通气量,并进行对比分析。主要观察指标:①各组观察对象血气分析和肺功能状况比较。②不同病程糖尿病患者的肺功能状况比较。结果:①各组观察对象血气分析和肺功能状况比较:与健康对照组比较,糖尿病组患者的肺活量、用力肺活量和肺通气功能都显著下降(t=1.999～2.301,P<0.05)。胰岛素依赖型与非胰岛素依赖型糖尿病患者的肺活量、用力肺活量、肺通气功能比较,差异无显著性意义(P>0.05)。②不同病程糖尿病患者的肺功能状况比较:病程>10年组糖尿病患者的肺功能状况明显劣于病程<10年组患者[肺活量(L):2.62±0.65,3.25±1.25;用力肺活量(L):2.40±0.52,3.21±0.98;第1秒用力呼气容积占用力肺活量比值:75.31±2.31,80.63±5.56;呼气流速峰值(L/s):4.33±0.68,5.98±1.02;最大通气量(L/s):76.22±6.98,89.21±5.69(t=2.012～2.350,P<0.05)]。结论:糖尿病患者的肺功能较正常人有减退的倾向,且病程较长的患者肺功能下降明显,临床工作中应予以密切重视。
Background: At present, the incidence of diabetes is on the rise. There are few reports on the status of pulmonary function in diabetic patients. OBJECTIVE: To compare the differences of pulmonary function between diabetic patients and normal subjects and to explore the relationship between the duration of diabetes and the changes of pulmonary function. Design: Case comparison. Unit: Wuhan University People’s Hospital. PARTICIPANTS: Ninety diabetic patients who were selected from the People’s Hospital of Wuhan University from January 2000 to December 2003 were selected voluntarily for observation. Insulin-dependent 20 cases, non-insulin-dependent 70 cases. In addition, 90 patients were divided into two groups according to 10-year disease course, 40 cases were less than 10 years and 50 cases were more than 10 years. Thirty healthy people with normal lung function were selected as healthy control group, all of whom were volunteers actively participating in the subject. Methods: The indexes of lung function, vital capacity, forced expiratory volume exponent force of 1 second, peak expiratory flow rate and maximum ventilation of each group were measured and compared. MAIN OUTCOME MEASURES: ① Comparison of blood gas analysis and pulmonary function status in each group. ② Diabetes patients with different duration of lung function status comparison. Results: ①Comparison of blood gas analysis and pulmonary function in each group: Compared with healthy control group, the lung capacity, forced vital capacity and pulmonary ventilation function of diabetic patients decreased significantly (t = 1.999-2.301, P <0.05). There was no significant difference in vital capacity, forced vital capacity and pulmonary ventilation between insulin-dependent and non-insulin-dependent diabetic patients (P> 0.05). Pulmonary function status in diabetic patients with different disease durations: The pulmonary function status of diabetic patients with disease duration> 10 years was significantly lower than that of patients with <10 years disease duration (L: 2.62 ± 0.65,3.25 ± 1.25); forced vital capacity (L) : 2.40 ± 0.52,3.21 ± 0.98; forced expiratory volume in 1 second occupied capacity spirometry ratio: 75.31 ± 2.31,80.63 ± 5.56; peak expiratory flow rate (L / s): 4.33 ± 0.68,5.98 ± 1.02; maximum ventilation (L / s): 76.22 ± 6.98, 89.21 ± 5.69 (t = 2.012 ~ 2.350, P <0.05)]. Conclusion: The lung function of patients with diabetes has a tendency of diminishing than that of normal people, and the lung function of patients with longer course of disease declines obviously and should pay close attention to in clinical work.