糖尿病足患者甲状腺功能状态及其影响因素分析  

Analysis of Thyroid Function Status and Its Influencing Factors in Patients with Diabetic Foot

作　　者：农丝洁 代平平 郑爱甜 覃晓洁[3] 吴标良[2] NONG Sijie;DAI Pingping;ZHENG Aitian;QIN Xiaojie;WU Biaoliang(Grade 2021,Major of Internal Medicine,Graduate School,Youjiang Medical University for Nationalities,Baise,Guangxi 533000,China;Department of Endocrinology,The Affiliated Hospital of Youjiang Medical University for Nationalities,Baise,Guangxi 533000,China;Intensive Care Unit,The Affiliated Hospital of Youjiang Medical University for Nationalities,Baise,Guangxi 533000,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]右江民族医学院附属医院内分泌科,广西百色533000 [3]右江民族医学院附属医院重症医学科,广西百色533000

出　　处：《中国烧伤创疡杂志》2024年第4期259-263,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：广西自然科学基金重点项目(2023GXNSFDA026008);广西医疗卫生适宜技术开发与推广应用项目(S2022134);广西壮族自治区中医药管理局科研项目(GXZYZ20210525、GZZC2020255);广西壮族自治区卫生健康委西医类别科研课题(20210234)。

摘　　要：目的 分析探讨糖尿病足患者甲状腺功能状态及其甲状腺功能异常的危险因素。方法 选取2016年1月至2023年6月右江民族医学院附属医院收治的110例糖尿病足患者作为研究对象,收集患者性别、年龄、体重指数等一般资料以及入院时白细胞计数、白蛋白、肌酐、甘油三酯、总胆固醇、空腹血糖、糖化血红蛋白、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平等资料,按照Wagner分级将患者分为W1组(Wagner 1级和Wagner 2级)、W2组(Wagner 3级)和W3组(Wagner 4级和Wagner 5级),同时根据患者是否存在甲状腺功能异常将其分为发生组和未发生组,分析不同Wagner分级糖尿病足患者甲状腺功能状态及糖尿病足患者甲状腺功能异常的相关危险因素。结果 110例糖尿病足患者甲状腺功能异常80例(72.73%),设为发生组;甲状腺功能正常30例(27.27%),设为未发生组。糖尿病足患者随着Wagner分级的升高,TT3、TT4、FT3水平逐渐降低(F/H=5.742、7.224、10.634,P=0.004、0.001、0.005),且W3组患者TT3、TT4、FT3水平均明显低于W1组和W2组(TT3:q=4.710、3.603,P=0.003、0.033;TT4:q=5.036、2.081,P=0.044、0.002;FT3:Z=3.174、2.719,P=0.005、0.020),而FT4、TSH水平3组间无明显差异(H=0.147、0.060,P=0.929、0.970)。多因素Logistic回归分析结果显示,甘油三酯、糖化血红蛋白水平较高是糖尿病足患者甲状腺功能异常的独立危险因素(95%CI为1.032~4.913、1.012~1.589,P=0.041、0.039)。结论 甲状腺功能与糖尿病足病变程度密切相关,且甘油三酯与糖化血红蛋白水平较高是糖尿病足患者甲状腺功能异常的独立危险因素。Objective To analyze the thyroid function status of patients with diabetic foot and risk factors for such patients to develop thyroid functional abnormities.Methods 110 patients with diabetic foot,admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2016 to June 2023,were selected as research subjects.Their data were collected,including general data such as sex,age,and body mass index,along with data on admission such as white blood cell count,albumin,creatinine,triglycerides,total cholesterol,fasting blood glucose,glycated hemoglobin,total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone(TSH)levels.Patients were divided into W1 group(Wagner grades 1 and 2),W2 group(Wagner grade 3),and W3 group(Wagner grades 4 and 5)based on the Wagner classification,and divided into the occurrence group and non-occurrence group according to whether they had complicated with abnormal thyroid functions,to analyze the thyroid function status of patients with diabetic foot at different Wagner severities,and the risk factors of such patients developing abnormal thyroid function.Results Among the 110 diabetic foot patients,80 cases(7273%)were complicated with abnormal thyroid function,being set as the occurrence group,and the other 30 cases(2727%)had normal thyroid function,being set as the non-occurrence group.As the Wagner grading level increased,the TT3,TT4,and FT3 levels of patients decreased gradually(F/H=5742,7224 and 10634,P=0004,0001 and 0005),and TT3,TT4,and FT3 levels in W3 group were all significantly lower than those in W1 and W2 group(TT3:q=4710 and 3603,P=0003 and 0033;TT4:q=5036 and 2081,P=0044 and 0002;FT3:Z=3174 and 2719,P=0005 and 0020).Although FT4 and TSH levels also decreased gradually,there were no significant differences among the three groups(H=0147 and 0060,P=0929 and 0970).Multivariate Logistic regression analysis indicated that higher triglyceride and HbA1c levels were independent risk factor

关 键 词：糖尿病足 2型糖尿病 甲状腺功能 甘油三酯 糖化血红蛋白 

分 类 号：R587.2[医药卫生—内分泌]