血糖控制水平对COPD伴2型糖尿病患者肺功能及其预后的影响  

Effect of Blood Glucose Control Level on Pulmonary Function and Prognosis in Patients with COPD and Type 2 Diabetes

作　　者：高小燕[1] 陈蓉[1] 卢慧宇[1] GAO Xiao-yan;CHEN Rong;LU Hui-yu(Department of Respiratory and Critical Care Medicine,Taizhou People's Hospital,Taizhou 225300,Jiangsu,China)

机构地区：[1]泰州市人民医院呼吸与危重症医学科

出　　处：《医学信息》2019年第16期76-79,共4页Journal of Medical Information

摘　　要：目的血糖控制水平对慢性阻塞性肺病(COPD)伴2型糖尿病(T2DM)患者肺功能及其预后的影响。方法选择2017年1月~2019年3月在我院呼吸内科接受治疗的COPD合并T2DM患者167例,根据患者住院期间血糖水平(MBG)不同分为MBG正常组108例和MBG高水平组59例;采用FEV1、FEV1/FVC、FVC、6min步行试验(6MWT)和mMRC呼吸困难表评分评估两组患者肺功能,世界卫生组织生活质量量表(WHOQOL-100)评估患者生活质量,比较两组超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)、动脉氧分压(PO2)、血浆D-二聚体(D-D)、动脉二氧化碳分压(PCO2)、临床疗效及不良反应发生情况。结果①本研究最终共纳入167例患者,MBG正常组108例,MBG高水平组59例;②治疗后,两组FEV1、FEV1/FVC、FVC、6MWT均较治疗前升高,mMRC呼吸困难表评分较治疗前下降,且MBG正常组较MBG高水平组改善明显,差异均有统计学意义(P<0.05);③两组FIB、PO2、D-D均较治疗前升高,hs-CRP、PCO2下降,且MBG正常组FIB、PO2、D-D、hs-CRP及PCO2改善程度优于MBG高水平组,差异均有统计学意义(P<0.05);④MBG正常组治疗总有效率为81.48%,高于MBG高水平组的57.63%,差异有统计学意义(P<0.05);MBG高水平组并发症发生率为35.59%,高于MBG正常组的14.81%,差异有统计学意义(P<0.05);⑤MBG正常组生活质量评分高于MBG高水平组,差异均有统计学意义(P<0.05)。结论COPD合并T2DM患者血糖控制水平与其治疗效果、生存质量及并发症发生率密切相关,血糖控制不佳易导致COPD疗效和患者生存质量降低、并发症发生风险升高。Objective The effect of blood glucose control on lung function and prognosis in patients with chronic obstructive pulmonary disease(COPD)with type 2 diabetes mellitus(T2DM).Methods 167 patients with COPD and T2DM who were treated in our Department of Respiratory Medicine from January 2017 to March 2019 were enrolled.According to the blood glucose level(MBG)during hospitalization,There were 108 cases of normal MBG group and 59 cases of MBG high level group;FEV1,FEV1/FVC,FVC,6 min walk test(6MWT)and mMRC breath The difficulty table score was used to evaluate lung function in the two groups.The World Health Organization Quality of Life Scale(WHOQOL-100)assessed the quality of life of the patients.The two groups were compared with high-sensitivity C-reactive protein(hs-CRP),fibrinogen(FIB),and arterial oxygen.Partial pressure(PO2),plasma D-dimer(D-D),arterial carbon dioxide partial pressure(PCO2),clinical efficacy and adverse reactions.Results①A total of 167 patients were enrolled in the study,108 in the normal MBG group and 59 in the high MBG group.②After treatment,the two groups of FEV1,FEV1/FVC,FVC and 6MWT were higher than before treatment,and the mMRC dyspnea score was lower than that before treatment,and the MBG normal group was significantly improved compared with the MBG high group,and the difference was statistically significant(P<0.05);③The levels of hs-CRP,FIB,PO2 and D-D in the two groups were higher than those before treatment,and PCO2 was decreased.The hs-CRP,FIB,PO2,D-D in the normal group were higher than those in the high MBG group,and the PCO2 was lower than the high level in the MBG group.All were statistically significant(P<0.05);④The total effective rate of MBG normal group was 81.48%,which was higher than that of MBG high level group 57.63%,the difference was statistically significant(P<0.05).The complication rate of MBG high level group was 35.59%,which was higher than that of MBG normal group 14.81%,the difference was statistically significant(P<0.05);⑤The quality of life score of th

关 键 词：COPD T2DM 血糖水平 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统] R587.1[医药卫生—内科学]