摘要
目的 :探讨糖皮质激素治疗对慢性阻塞性肺疾病 (COPD)急性发作期患者糖代谢的影响。方法 :采用OGTT和胰岛素释放试验检测COPD急性发作期患者静点地塞米松后血糖及胰岛素水平。结果 :1 中重度低氧血症者空腹血糖及血浆胰岛素水平明显升高 ,血糖与PaO2 呈显然负相关 (r =- 0 5 2 4 2 ,p <0 0 5 ) ;2 中重度低氧血症者各时点血糖水平显著性升高与轻度低氧血症者相比 ,有显著性差异 (p <0 0 5 ,p <0 0 0 1) ,耐糖曲线峰值在糖负荷后 1～ 2小时 ;3 应用糖皮质激素后 ,糖负荷后半小时、1小时血糖明显高于治疗前 ,耐糖曲线高峰前移 ,胰岛素释放水平均明显高于治疗前 ,治疗前后对比存在显著性差异 (p <0 0 5 )。结论 :COPD急性发作期合并低氧血症患者存在糖耐量减低 ,应用糖皮质激素使上述损害加重。
Objective To study the effect of glucocorticoids therapy upon glucose metabolism in COPD patients with actute exacerbation. Methods Plasma glucose and insulin levels in COPD patients after intravenous adminstration of l0mg dexamethasone daily for 5 days were determined oral with glucose tolerance test (OGTT) and insulin release test (IRT). Results 1) The levels of basal plasma glucose and insulin were significantly higher in severe hypoxemic group than those in moderate hypoxemic group ( p<0 05,p<0 001 ). There was a marked negative correlation between the level of plasma glucose and PaO 2( r=-0 5242,p <0 05). 2) The levels of plasma glucose in intermediate and severe hypoxemic groups were remarkably higher ( p <0 05) than those in mild group. The two peak times of glucose curve were observed at one and two hour after oral glucose load. 3) After the administration of glucocorticoids, at half an hour and one hour plasma glucose levels were significantly higher than those before, the peak time of glucose levels appeared earlier and the insulin release levels were higher than they were before therapy ( p <0 05). Conclusion COPD patients with acute exacerbation complicated with hypoxemia had problems of impaired glucose tolerance. The administration of glucocorticoids made the impairment worse.
出处
《放射免疫学杂志》
CAS
2002年第5期263-265,共3页
Journal of Radioimmanology
