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目的探讨2型糖尿病肾病患者的肺功能改变及其意义。方法 90例2型糖尿病肾病Ⅲ～V期患者,每期各30例;对照组为30例健康体检者。采用美国森迪斯大型肺功能仪测定肺通气及肺弥散功能,比较糖尿病肾病不同分期的肺功能变化。结果 2型糖尿病肾病患者肺通气及肺弥散功能均有变化。与对照组相比,糖尿病肾病患者的DLCO、DLCO(%)、DLCO/VA、DLCO/VA(%)等肺弥散功能指标随病期的进展呈依次递降(P<0.05),除Ⅲ期外,与对照组的差异均有统计学意义(P均<0.01);Ⅲ、Ⅳ、Ⅴ期之间两两比较,差异亦有统计学意义(P<0.05或P<0.01)。与对照组相比,Ⅲ、Ⅳ、Ⅴ期患者的VC、VC(%)、FEV1、FEV1(%)等通气功能指标呈依次递降(P<0.05);其中Ⅳ期的VC(%)、FEV1(%)显著低于对照组(P均<0.01);V期的VC、VC(%)、FEV1、FEV1(%)显著低于对照组(P<0.05或P<0.01)。结论 2型糖尿病肾病患者存在肺功能的损害,且糖尿病肾病越严重,肺弥散和通气功能损害越明显。
Objective To investigate the changes of pulmonary function in patients with type 2 diabetic nephropathy and its significance. Methods Ninety patients with type 2 diabetic nephropathy from stage Ⅲ to stage V were selected, with 30 cases in each stage. The control group consisted of 30 healthy subjects. Pulmonary ventilation and pulmonary diffuse function were measured by the American Sendes large-scale pulmonary function test, and the changes of pulmonary function in different stages of diabetic nephropathy were compared. Results Patients with type 2 diabetic nephropathy both had changes in pulmonary ventilation and pulmonary diffuse function. Compared with the control group, the indexes of diffuse lung function such as DLCO, DLCO (%), DLCO / VA and DLCO / VA (%) in patients with diabetic nephropathy decreased with the progression of disease (P <0.05) (P <0.01 or P <0.01). There was also a significant difference between the two groups in the stages Ⅲ, Ⅳ and Ⅴ (P <0.05 or P <0.01). Compared with the control group, the ventilatory function indexes of VC, VC (%), FEV1, FEV1 (%) in patients with stage Ⅲ, Ⅳ and Ⅴ decreased in descending order (P < (P <0.01). The VC, VC (%), FEV1, FEV1 (%) in V stage were significantly lower than those in control group (P <0.05 or P <0.01). Conclusion Patients with type 2 diabetic nephropathy have impaired pulmonary function, and the more severe the diabetic nephropathy is, the more obvious is the impairment of lung diffusion and ventilation.