小剂量左甲状腺素三联治疗糖尿病合并甲状腺功能亢进的疗效  

Effects of low-dose levothyroxine triple therapy on diabetes mellitus combined with hyperthyroidism

作　　者：刘帆 刘彤[1] 孟银苹 LIU Fan;LIU Tong;MENG Yinping(Department of Endocrinology,Baoding Second Central Hospital,Baoding 072750,China)

机构地区：[1]保定市第二中心医院内分泌科,保定072750

出　　处：《西北药学杂志》2023年第2期147-150,共4页Northwest Pharmaceutical Journal

基　　金：保定市科技计划项目(编号:2041ZF028)。

摘　　要：目的 观察小剂量左甲状腺素、甲巯咪唑联合达格列净治疗糖尿病合并甲状腺功能亢进(甲亢)的临床疗效。方法 选取76例糖尿病合并甲亢患者,随机分为治疗组与对照组,每组38例,对照组予以巯咪唑联合达格列净进行治疗,治疗组在对照组治疗的基础上予以小剂量左甲状腺素治疗。比较治疗后2组患者的临床疗效,治疗前后血糖指标[空腹血糖(fasting blood glucose, FBG)、餐后2 h血糖(2 hours’ postprandial plasma glucose, 2hPG)和糖化血红蛋白(hemoglobin A1c, HbAlc)]、血脂指标[三酰甘油(triglyceride, TG)、总胆固醇(total cholesterol, TC)和低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)]、甲状腺激素指标[(游离三碘甲状腺原氨酸(free triiodothyronine, FT3)、促甲状腺素(thyroid stimulatinghormone, TSH)和游离四碘甲状腺素(free thyroxine, FT4)]和骨代谢指标[骨钙素(bone glaprotein, BGP)、碱性磷酸酶(alkaline phosphatase, ALP)和降钙素(calcitonin, CT)]以及治疗期间不良反应发生的情况。结果 治疗后,总有效率治疗组(71.05%)明显高于对照组(44.74%)(P<0.05);2组患者的FBG、2hPBG和HbA1c水平均低于治疗前,且治疗组明显低于照组(P<0.05);2组TG、TC和LDL-C的水平均低于治疗前,且治疗组明显低于对照组(P<0.05);2组FT3和FT4水平均低于治疗前,TSH水平高于治疗前,且治疗组FT3和FT4水平均低于对照组(P<0.05),TSH水平明显高于对照组(P<0.05);2组BGP、ALP和CT水平均低于治疗前,且治疗组均明显低于对照组(P<0.05)。治疗期间2组不良反应发生情况无明显差异。结论 小剂量左甲状腺素、甲巯咪唑联合达格列净治疗糖尿病合并甲亢临床疗效佳,可以降低血糖、血脂和甲状腺激素水平,促进骨骼健康,且安全性好。Objective To observe the clinical curative effects of low-dose levothyroxine and methimazole combined with dapagliflozin on diabetes mellitus combined with hyperthyroidism.Methods A total of 76 patients with diabetes mellitus and hyperthyroidism were enrolled and randomly divided into treatment group and control group, 38 cases in each group. The control group was treated with methimazole and dapagliflozin, while the treatment group was treated with low-dose levothyroxine on the basis of control group. The clinical curative effect after treatment, blood glucose indexes [fasting blood glucose(FBG), 2 hours postprandial plasma glucose(2hPG), hemoglobin A1c(HbAlc)], blood lipid indexes [triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C)], thyroid hormone indexes [free triiodothyronine(FT3), thyroid stimulating hormone(TSH), free thyroxine(FT4)] and bone metabolism indexes [bone glaprotein(BGP), alkaline phosphatase(ALP), calcitonin(CT)] before and after treatment, and adverse reactions during treatment were compared between the 2 groups.Results After treatment, the total response rate in treatment group was significantly higher than that in control group(71.05% vs. 44.74%)(P<0.05). After treatment, the levels of FBG, 2hPBG and HbA1c in both groups were decreased, which were significantly lower in treatment group than in control group(P<0.05). After treatment, the levels of TG, TC and LDL-C in both groups were decreased, which were significantly lower in treatment group than in control group(P<0.05). After treatment, the levels of FT3and FT4were decreased, while the TSH level was increased in both groups. After treatment, levels of FT3and FT4in treatment group were lower than those in control group(P<0.05), while the TSH level was significantly higher than that in control group(P<0.05). After treatment, the levels of BGP, ALP and CT in both groups were decreased, which were significantly lower in treatment group than in control group(P<0.05). There was no significant difference in the

关 键 词：左甲状腺素 甲巯咪唑 达格列净 小剂量 糖尿病合并甲状腺功能亢进 

分 类 号：R977.1[医药卫生—药品]