老年糖尿病合并高血糖高渗状态患者甲状腺功能的变化

Clinical analysis of changes of thyroid function in elderly diabetic patients with hyperglycemic hyperosmolar status

目的探讨老年糖尿病合并高血糖高渗状态患者甲状腺功能的变化。方法分析2009年1月—2013年1月在本院接受治疗的糖尿病患者临床资料,依据是否发生高血糖高渗状态分为观察组(高血糖高渗状态)65例和对照组(无高血糖高渗状态)45例。结果观察组血糖水平、血钾水平、血钠水平、血渗透压、剩余碱均显著高于对照组(P<0.05)。观察组T3水平、T4水平及FT4水平均显著低于对照组(P<0.05)。至治疗后4d,观察组T3、T4及FT4均显著高于治疗前(P<0.05)。结论老年糖尿病合并高血糖高渗状态会导致继发性甲状腺功能低下及一系列电解质酸碱平衡紊乱,治疗后甲状腺功能可恢复。

Objective To observe the changes of thyroid function in elderly diabetic patients with hyperglycemic hyperosmolar status （HHS）. Methods Clinical material of diabetic elderly patients with hyperosmolar hyperglycemic state from 2009 to 2013 was retrospectively analyzed. Patients were divided into observation group and control group according to the occurrence of hyperosmolar hyperglycemic state. There were 65 elderly diabetics patients with HHS in observation group and 45 diabetic elderly patients without HHS in the control group. Results Patients in the observation group had higher levels of blood glucose, serum potassium, blood sodium, blood osmotic and base excess than that in the control group and the difference was statistically significant （ P 〈 0.05 ）. The levels of T3, T4 and FT4 were lower in the observation group than that in the control group, the difference was statistically significant （P 〈 0.05 ）. After 4 days of treatment, patients in the observation group had higher levels of T3 , T4 and FT4 than that of prior treatment, so the difference was statistically significant（P 〈 0.05 ）. Conclusion HHS of elderly diabetic patients could lead to the secondary hypofunction of thyroid and a series of acid base disturbance. With the treatment, the function of thyroid could be recovered.