2型糖尿病患者甲状腺功能的调查分析

Thyroid Function Investigation and Analysis of Patients with Type 2 Diabetes

目的：分析2型糖尿病患者甲状腺功能。方法检测西安市第一医院2010年1月～2011年5月208例（男102例，女106例）已被确诊为2型糖尿病的住院患者（30岁～80岁）血清中TSH，FT3和FT4水平。对照组为100例门诊体检非糖尿病患者（30岁～80岁）。采集空腹静脉血并以电化学发光酶免疫分析法捡l刹其甲状腺功能。结果100例门诊体检非糖尿病患者甲状腺异常发生率11％，208例2型糖尿病患者中甲状腺异常者80例，发生率为38．5％，明显高于正常对照组（P＜O．05）。其中临床甲亢、亚临床甲亢、临床甲减、亚临床甲减的患病率分别为4．3％（9／208），10．6％（22／208），6．3％（13／208）和17．3％（36／208）；甲状腺功能减退者（23．5％）明显高于甲状腺功能亢进者（14．8％），差异有统计学意义（P＜O．05），尤其以亚甲减多见（17．3％）；且女性（26．O％）明显高于男性（12．5％），差异有统计学意义（P＜O．05）。与甲状腺功能正常的糖尿病患者相比，糖尿病患者中甲减或亚甲减患者年龄、糖尿病病程比较差异有统计学意义（P＜O．05）。结论与非糖尿病患者相比，2型糖尿病患者甲状腺异常发生率较高尤以甲减或亚甲减较为常见且女性多于男性，同时受患者年龄和糖尿病病程的影响。因此，应常规筛查甲状腺功能，定期随访促甲状腺素以提高亚临床甲减的检出率。

Objective To analysis of thyroid function in patients with type 2 diabetes. Methods Collected 208 cases that had been diagnosed with type 2 diabetes mellitus inpatients from the First Hospital of Xi＇an in January 2010 to May 2011 （male 102, female 106）. The control group of 100 cases of outpatient physical non-diabetic patients （aged 30-80 years old）. That serum TSIq,FT3 and FT4 of above two group were detected with chemiluminescence enzyme immunoassay. Results 100 ca- ses of outpatient service medical thyroid abnormality of diabetes rate was 11%. In 208 cases of type 2 diabetes patients of thyroid abnormalities,80 cases had thyriod discrepancy and incidence rate was 38. 5 %. There was significantly higher than normal control group （P〈0.05）. Among them, the prevalence rates of clinical hyperthyroidism, subclinical hypothyroidism were 4.3% （9/208） ,10.6% （22/208）, 6.3% （13/208） and 17.3% （36/208）, respectively. Hypothyroidism（23. 5%） was significantly higher than hyperthyroid （14.8%, P〈0. 05） and female （26.0%） significantly higher than male（12.5 %, 〈 0. 05）. With normal thyroid function in patients with diabetes compared in patients with diabetes hypothyroidism or subclini- cal hypothyroidism patients age,diabetes duration had a significant difference （P^0.05）. Conclusion Compared with non- diabetic patients,patients with type 2 diabetes and thyroid abnormalities occured at a higher rate and excellent in hypothy- roidism or subclinical hypothyroidism was more commons and more women than men. It was influenced by age and duration of diabetes patients. Therefore,routine screening for thyroid function,periodic follow-up of subclinical hypothyroidism thy- rotronin can increase detection rate.