糖尿病患者治疗前后的甲状腺功能变化  

Changes of thyroid function before and after metabolic control in diabetics

作　　者：张南雁[1] 赵伯钦[1] 南耘[1] 张雅萍[1] 

机构地区：[1]第四军医大学西京医院内分泌科

出　　处：《第四军医大学学报》1998年第3期302-304,共3页Journal of the Fourth Military Medical University

摘　　要：目的：观察糖尿病患者治疗前后的甲状腺功能变化．方法：测定４０名未经控制的糖尿病患者甲状腺功能指标，并将患者分为无并发症组（Ａ组）、急性并发症组（Ｂ组）及慢性并发症组（Ｃ组）．其中２７例经治疗空腹血糖持续稳定在７．２ｍｍｏｌ／Ｌ以下达２ｍｏ，复查甲状腺功能．结果：与正常对照组相比，糖尿病患者治疗前血清ｒＴ３明显增高（Ｐ＜０．０１），Ｔ３，Ｔ４，ＦＴ３，ＦＴ４及Ｔ３／ｒＴ３比值均明显降低（Ｐ＜０．０５），Ｂ，Ｃ两组这种变化更为显著，Ｂ组并伴有ＴＳＨ的降低（Ｐ＜０．０５）．治疗后Ａ组甲状腺激素恢复正常，Ｂ组仅部分恢复，Ｃ组无明显恢复．结论：糖尿病代谢紊乱及其急、慢性并发症可能从不同水平影响甲状腺功能．纠正高血糖。Aim: To investigate the changes of thyroid function before and after metabolic control in diabetics. Methods: Parameters of thyroid function were measured from 40 uncontrolled diabetics and 20 nondiabetic controls. The diabetics were divided into 3 groups:group A (without complication), group B (acute complication) and group C (chronic complication). The thyroid function parameters were reexa mined in 27 diabetics whose fasting blood glucose (FBG) was well controlled below 7.2 mmol/L for 2 mo. Results: Before metabolic control,serum rT 3 concentrations were significantly increased ( P <0.01) and T 3, T 4, FT 3, FT 4 levels, rT 3/T 3 ratio were significantly decreased ( P <0.05) in diabetics in comparison with nondiabetic controls.Those changes were more outstanding in groups B and C than in group A. Serum TSH level was lower in group B( P < 0.05 ) than in nondiabetic controls. After metabolic control, the changes of thyroid hormones in group A returned to the levels of controls. Those in group B returned in part and there were no marked restoration in group C. Conclusion: Hyperglycemia,acute and chronic complication in diabetics might affect thyroid function parameters from various aspects.After metabolic control, the recovery degree of thyroid function in various groups is different.

关 键 词：糖尿病 药物疗法 并发症 甲状腺功能 

分 类 号：R587.1[医药卫生—内分泌] R584[医药卫生—内科学]