糖尿病患者血清甲状腺激素测定的临床意义

摘要

目的 探讨游离甲状腺激素与糖尿病(diabetes mellitus,DM)病情、病程及并发症的关系.方法 选择2010年1月至2011年12月住院及门诊确诊的糖尿病患者100例和健康体检者50名,按糖尿病类型、病程、并发症等分组观察,采用RIA测定血清游离甲状腺激素.观察不同糖尿病分组FT3、FT4含量变化特点.结果 DM组甲状腺功能异常总发病率为24.0％,女性患者发病率明显高于男性,差异有统计学意义(x2=4.70,0.01＜P＜0.05).DM组FT3、FT4低于健康对照组,1型DM组低于2型DM组(P＜0.01)；随着病程延长,FT3呈降低趋势,FT4无显著性差异(P＞0.05)；糖尿病肾病和酮症酸中毒组FT3、FT4显著低于无并发症组(P＜0.05).结论 糖尿病患者FT3、FT4存在不同程度的降低,FT3、FT4可作为判断糖尿病病情、疗效观察和预后估计的指标.%Objective To investigate the correlation between thyroid hormone and patient' s condition, course of disease and complication in patients with diabetes mellitus (DM). Methods 100 patients with DM diagnosed between January 2010 and December 2012 were divided into different groups according to disease type, condition, and complication of DM. The serum level of free serum thyroid hormone FT3 and FT4 in MD patients and 50 healthy controls were determined by RIA. Results The percentage of abnormal thyroid function in DM group was 24% , and the ratio in female patients was higher than that of male patients (P <0. 05). The serum level of FT3 and FT4 in DM group was significantly lower than that of in healthy control group, and FT3 and FT4 levels in Type 1 DM was lower than that of in Type 2 DM ( P < 0. 01). With the course of disease prolongs, there was a significant decreasing in FT3 level, while FT4 showed almost no changes (P > 0.05). The serum FT3 and FT4 levels in complicated group were significantly lower than that of with diabetic nephropathy and DKA. Conclusion The serum levels of FT3 and FT4 in patients with diabetes mellitus show some degree of decrease, and they may be used as an indicator for the diagnosis and evaluation of treatment of patients with diabetes mellitus.