[1]邱俊霖.糖尿病酮症酸中毒患者甲状腺功能状态分析[J].国际内分泌代谢杂志,2017,37(06):376-380.
　Qiu Junlin..Analysis of thyroid function in patients with diabetic ketoacidosis[J].International Journal of Endocrinology and Metabolism,2017,37(06):376-380.
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糖尿病酮症酸中毒患者甲状腺功能状态分析()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
37
期数:
2017年06期
页码:
376-380
栏目:
论著
出版日期:
2017-11-20

文章信息/Info

Title:
Analysis of thyroid function in patients with diabetic ketoacidosis
作者:
邱俊霖
536000 北海,广西医科大学第九附属医院内分泌代谢科
Author(s):
Qiu Junlin.
Department of Endocrinology and Metabolism, The 9th Affiliated Hospital of Guangxi Medical University, Beihai 536000, China
关键词:
糖尿病酮症酸中毒;  甲状腺功能;  糖尿病
Keywords:
Diabetic ketoacidosis;  Thyroid function;  Diabetes mellitus
文献标志码:
A
摘要:
目的 分析糖尿病酮症酸中毒(DKA)患者甲状腺功能(甲功)状态。方法 选择广西医科大学第九附属医院2005年11月至2013年12月住院DKA患者93例,并按性别、年龄(≤30岁组、30～60岁组、≥60岁组)、糖尿病分型(1型糖尿病、2型糖尿病)进行分组,测定各组血清FT3、FT4、促甲状腺激素(TSH)水平,并进行比较。结果 甲功正常的病态综合征(ESS)发生率为79.6%(74/93),甲功正常为 9.7%(9/93),甲状腺功能亢进症发生率为 7.5%(7/93),亚临床甲状腺功能亢进症发生率为 2.2%(2/93),甲状腺功能减退症发生率为1.1%(1/93)。男性组DKA患者的FT3水平低于女性组(t=-2.046,P=0.044),FT4、TSH比较差异无统计学意义; 1型糖尿病组FT4水平低于2型糖尿病组(t=-2.352,P=0.021),但TSH高于2型糖尿病组(t=2.454,P=0.016),FT3比较差异无统计学意义(P>0.05)。1型糖尿病组低T3/T4综合征比例高于2型糖尿病组(χ2=4.443,P=0.035)。低T3综合征比例随着年龄增加有增加的趋势(χ2=7.081,P=0.029); 低T3/T4综合征比例随着酸中毒严重程度的增加有增加的趋势(χ2=6.759,P=0.034)。结论 DKA患者甲功异常发生率较高,甲功异常表现形式多样,ESS最常见。
Abstract:
Objective To investigate the thyroid function of patients with diabetic ketoacidosis(DKA).Methods A total of 93 DKA patients admitted to the 9th Affiliated Hospital of Guangxi Medical University from November 2005 to December 2013 were selected and divided into subgroups according to age(≤30 years, 30-60 years, and ≥60 years), gender(male, female)and type of diabetes [(type 2 diabetes mellitus(T2DM), type 1 diabetes mellitus(T1DM)]. FT3, FT4 and thyroid stimulating hormone(TSH)were measured and compared among groups.Results 79.6%(74/93)of patients with DKA were found with euthyroid sick syndrome(ESS), 9.7%(9/93)had normal thyroid function, 7.5%(7/93)had hyperthyroidism, 2.2%(2/93)were with subclinical hyperthyroidism, and 1.1%(1/93)were diagnosed with hypothyroidism. The level of serum FT3 was lower in male group than that in female group(t=-2.046, P=0.044), whereas the levels of FT4, TSH had no differences between male group and female group.Compared with T2DM group, T1DM group had lower FT4 level(t=-2.352, P=0.021), higher TSH level(t=2.454, P=0.016), and FT3 level had no difference(P>0.05). The proportion of low T3/T4 syndrome in T1DM group was higher than that in T2DM group(χ2=4.443, P=0.035). The percentage of low T3 syndrome tended to increase with age(χ2=7.081, P=0.029), whereas the proportion of low T3/T4 syndrome tended to increase with the severity of ketoacidosis(χ2=6.759, P=0.034).Conclusions The incidence of thyroid dysfunction in patients with DKA is high, and have various manifestations. ESS is the most common type of thyroid dysfunction.

参考文献/References:

[1] Tervaert TW, Mooyaart AL, Amann K, et al. Pathologic classification of diabetic nephropathy[J].J Am Soc Nephrol,2010,21(4):556-563. DOI:10.1681/ASN.2010010010.
[2] Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference[J].Am J Kidney Dis,2014,64(4):510-533. DOI:10.1053/j.ajkd.2014.08.001.

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备注/Memo

备注/Memo:
基金项目:广西医药卫生项目(Z2016083)
通信作者:邱俊霖,Email: qjl497@163.com
更新日期/Last Update: 2017-11-30