| Objective: To investigate the changes of pulmonary function in patients with type 2 diabetes mellitus in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its possible influencing factors.Methods: 1?55 of AECOPD patients with type 2 diabetes mellitus hospitalized in the Department of Respiratory Medicine of the First Hospital of Jilin University from September 2014 to October 2018 were selected as the experimental group.33 of AECOPD patients without diabetes mellitus who were hospitalized in the Department of Respiratory Medicine at the same time were selected as the control group.The pulmonary function,fasting blood-glucose,glycosylated hemoglobin,random blood glucose and high-sensitivity C-reactive protein were measured,and the differences of pulmonary function between the two groups were compared.According to the guidelines for the prevention and treatment of type 2 diabetes in China,the blood glucose control was divided into two groups: the group with good blood glucose control(28 cases)and the group with poor blood glucose control(27 cases).The differences of pulmonary function indexes and hs-CRP levels among the groups were compared.Then the experimental group was divided into two groups according to the course of diabetes: the group with diabetes duration of more than 5 years(29 cases)and the group with diabetes duration of less than 5 years(26 cases).The differences of various indexes of pulmonary function among the groups were compared.2?All data collected were processed by SPSS18 software.Normal distribution measurements(such as age,smoking index,pulmonary function level,hs-CRP)were expressed by(x ±s).T-test was used for comparison between the two groups and factor analysis of variance was used for comparison between the two groups.Counting data(such as gender)were compared by chi-square test.The above data processing P < 0.05 indicates that the difference is statistically significant.Results: 1.There was no significant difference in age,sex and smoking index between the experimental group and its subgroups and the control group.2.There was a significant difference in the percentage of the actual DLCO/VA to the predicted value between the experimental group(66 ±27)% and the control group(82±23)%(t=-2.836,P=0.006 < 0.01),while there was no significant difference in other pulmonary function indexes(P>0.05).3.There was a significant difference in the percentage of actual DLCO/VA to the predicted value between the poor glycemic control group(61±30)% and the control group(82±23)%(P=0.007 < 0.01).There was a significant difference in the percentage of actual DLCO to the predicted value between the group with poor blood glucose control(41±17)% and the group with good blood glucose control(57±30)%(P=0.022 < 0.05),and between the group with good blood glucose control(58±16)% and the control group(P=0.011 < 0.05).There was no significant difference between the good blood glucose control and the control group(P=1.000>0.05).The level of hs-CRP in the group with poor control of blood glucose was higher than that in the group with good control of blood glucose and the control group,but there was no significant difference among the three groups(P=0.34>0.05).4.On DLCO% pred,there was significant difference between the experimental group with diabetes duration of more than 5 years(44±15)% and the control group(58±16)%(P=0.041<0.05).On DLCO/VA%pred,there was a significant difference between experimental group with diabetes duration of more than 5 years(59±22)% and control group(82±23)%(P=0.001<0.05).Conclusions: 1.Compared with patients with simple AECOPD,the diffusion function of patients with AECOPD and type 2 diabetes mellitus decreased significantly,while the ventilation function did not change significantly.2.The degree of poor blood sugar control in patients with AECOPD is proportional to the degree of impaired pulmonary diffusion function,and this effect is not related to the level of inflammatory response.3.Dissemination dysfunction of AECOPD patients with type 2 diabetes mellitus is related to the course of diabetes mellitus. |
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