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糖尿病合并微量白蛋白尿患者肺弥散功能的评估

The assessment of pulmonary diffusing capacity in diabetes mellitus with regard to microalbuminuria.

作者信息

Saler Tayyibe, Cakmak Gulfidan, Saglam Zuhal Aydan, Ataoglu Esra, Yesim Erdem Tijen, Yenigun Mustafa

机构信息

The 4th Clinic of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

Intern Med. 2009;48(22):1939-43. doi: 10.2169/internalmedicine.48.2417. Epub 2009 Nov 16.

Abstract

OBJECTIVE

The current study was conducted to determine whether or not the lung is one of the target organs in the development of vascular complications in diabetic patients. We also investigated the relationship between pulmonary diffusing capacity and microalbuminuria.

MATERIALS AND METHODS

A total of 68 patients with type 2 diabetes and 44 with type 1 diabetes (male/female [M/F] n=19/49 and 15/29; age: 52.4+/-8.8 and 32.5+/-11 years;) and 80 healthy controls (M/F=22/58; age=40.1+/-12.4 years) were recruited for the study. All of the participants were evaluated with simple spirometric tests and a simple breath carbon monoxide (CO) diffusion test. CO lung diffusion capacity (DLCO) and the ratio of DLCO value to the alveolar volume (VA) were used to assess alveolar membrane permeability (DLCO/VA). Urinary albumin excretion (UAE) per day of the participants was also evaluated.

RESULTS

DLCO, DLCO% and DLCO/VA% values were significantly lower in diabetics than in the control group (p=0.006; p=0.039; p=0.003, respectively). UAE was inversely correlated with DLCO, DLCO/VA, DLCO/VA% and DLCO% (p=0.050; p=<0.001; p=0.001; p=0.004, respectively).

CONCLUSION

This study demonstrated that alveolar gas exchange capacity is significantly decreased in diabetic patients. Microalbuminuria may be one of the predictors of this decline.

摘要

目的

进行本研究以确定肺是否为糖尿病患者血管并发症发生发展过程中的靶器官之一。我们还研究了肺弥散功能与微量白蛋白尿之间的关系。

材料与方法

本研究共纳入68例2型糖尿病患者、44例1型糖尿病患者(男性/女性[M/F]分别为19/49和15/29;年龄分别为52.4±8.8岁和32.5±11岁)以及80名健康对照者(M/F = 22/58;年龄 = 40.1±12.4岁)。所有参与者均接受了简易肺量计测试和简易呼气一氧化碳(CO)弥散测试。采用CO肺弥散量(DLCO)以及DLCO值与肺泡容积(VA)的比值来评估肺泡膜通透性(DLCO/VA)。还对参与者每日的尿白蛋白排泄量(UAE)进行了评估。

结果

糖尿病患者的DLCO、DLCO%和DLCO/VA%值显著低于对照组(分别为p = 0.006;p = 0.039;p = 0.003)。UAE与DLCO、DLCO/VA、DLCO/VA%和DLCO%呈负相关(分别为p = 0.050;p < 0.001;p = 0.001;p = 0.004)。

结论

本研究表明糖尿病患者的肺泡气体交换能力显著下降。微量白蛋白尿可能是这种下降的预测指标之一。

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