老年糖尿病合并酮症酸中毒患者血清甲状腺激素水平研究

Thyroxine Level in Elderly Patients with Diabetic Ketoacidosis

目的探讨老年糖尿病合并酮症酸中毒患者甲状腺激素水平变化情况。方法选取2007年6月—2012年3月在我院住院的老年2型糖尿病患者143例,其中69例合并酮症酸中毒(A组),74例不合并酮症酸中毒(B组)。比较两组患者的临床指标及甲状腺激素〔包括总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)〕水平。之后A组按照酮症酸中毒的治疗原则治疗,而B组仅给予糖尿病常规治疗。治疗3周后,复查并比较两组患者的甲状腺激素水平。两组间均数比较采用t检验。结果与B组比较,治疗前A组患者TT3、FT4、TT4水平下降,两组间差异有统计学意义(P<0.01);而经过3周的治疗,A组患者TT3、FT4、TT4水平较治疗前显著升高(P<0.01),且与B组比较差异无统计学意义(P>0.05)。结论老年糖尿病合并酮症酸中毒患者TT3、FT4、TT4水平下降;但经过治疗,酮症酸中毒纠正后患者TT3、FT4、TT4水平恢复。

Objective To observe the thyroxine level in elderly patients with diabetic ketoacidosis(DKA).Methods A total of 143 elderly patients with type 2 diabetes mellitus(T2DM) admitted to our hospital from June 2007 to March 2012 were divided into groups A(n=69,combined with ketoacidosis),B(n=74,without ketoacidosis).The clinical indicators and the levels of thyroid hormone(including total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH)) were compared.And then group A treated based on the principle of DKA treatment,group B treated conventionally.After 3 weeks of treatment,the thyroid hormone levels were compared.t-test was used.Results Before treatment,the levels of TT3,FT4,TT4 were lower in group A than in group B,the difference was significant(P<0.01).After 3 weeks of treatment,the levels of TT3,FT4,TT4 of group A increased significantly(P<0.01),not different from those of group B(P>0.05).Conclusion The levels of TT3,FT4,TT4 decrease in elderly DKA patients,but return to normal after treatment.