【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。更多还原

【Abstract】 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.更多还原