糖尿病酮症酸中毒时甲状腺激素水平变化分析  

Changes of thyroid hormone levels in diabetic ketoacidosis

作　　者：金红梅 JIN Hong-mei(Department of Endocrinology,Yanbian University Affiliated Hospital,Yanji 133000,China)

机构地区：[1]延边大学附属医院内分泌科,133000

出　　处：《中国实用医药》2020年第30期45-47,共3页China Practical Medicine

摘　　要：目的探讨糖尿病酮症酸中毒时甲状腺激素水平的变化。方法120例糖尿病患者,根据病情分为A组(2型糖尿病酮症酸中毒)、B组(2型糖尿病酮症)、C组(单纯2型糖尿病),每组40例。检测三组患者的血糖指标、甲状腺激素指标水平及低三碘甲状腺原氨酸(T3)综合征发生率,并进行比较。结果A组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平均明显高于B组和C组,差异具有统计学意义(P<0.05)。B组FPG、2 h PG、HbA1c水平均明显高于C组,差异具有统计学意义(P<0.05)。A组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平分别为(1.92±1.10)pg/ml、(0.34±0.12)ng/dl,均明显低于B组的(2.68±1.13)pg/ml、(0.88±0.17)ng/dl和C组的(2.98±1.14)pg/ml、(0.94±0.16)ng/dl,差异具有统计学意义(P<0.05);B组、C组FT3、FT4水平比较差异无统计学意义(P>0.05);三组促甲状腺素(TSH)水平比较差异无统计学意义(P>0.05)。A组低T3综合征发生率为10.00%,高于B组的0、C组的0,差异具有统计学意义(P<0.05)。结论糖尿病酮症酸中毒时甲状腺激素FT3、FT4明显降低,可能发生低T3综合征,测定甲状腺激素水平可为临床判断糖尿病病情提供可靠依据。Objective To discuss the changes of thyroid hormone levels in diabetic ketoacidosis.Methods A total of 120 patients with diabetes mellitus were divided into group A(type 2 diabetic ketoacidosis),group B(type 2 diabetic ketosis),group C(simple type 2 diabetes mellitus)according to condition of disease,with 40 cases in each group.The blood glucose index,thyroid hormone index level and the incidence of low triiodothyronine(T3)syndrome were detected and compared in the three groups.Results The levels of fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c)of group A were obviously higher than those of group B and group C,and the difference was statistically significant(P<0.05).The levels of FPG,2 h PG and HbA1c of group B were obviously higher than those of group C,and the difference was statistically significant(P<0.05).The levels of free triiodothyronine(FT3),free thyroxine(FT4)of group A were(1.92±1.10)pg/ml and(0.34±0.12)ng/dl,which were obviously lower than those of group B[(2.68±1.13)pg/ml and(0.88±0.17)ng/dl]and group C[(2.98±1.14)pg/ml and(0.94±0.16)ng/dl],and the difference was statistically significant(P<0.05).There was no statistically significant difference in levels of FT3 and FT4 between group B and group C(P>0.05).There was no statistically significant difference in thyroid-stimulating hormone(TSH)levels among three groups(P>0.05).The incidence of low T3 symptom of group A was 10.00%,which was higher than 0 and 0 of group B and group C,and the difference was statistically significant(P<0.05).Conclusion In diabetic ketoacidosis,the thyroid hormones FT3 and FT4 are significantly reduced,and low T3 syndrome may occur.Determination of thyroid hormone levels can provide a reliable basis for clinical judgment of diabetes mellitus.

关 键 词：糖尿病 酮症酸中毒 甲状腺激素 

分 类 号：R587.2[医药卫生—内分泌]