糖尿病合并甲状腺功能亢进的临床特点和诊疗分析

Clinical Characteristics and Diagnosis Analysis in Diabetic Patients with Hyperthyroidism

目的 研究探讨糖尿病（DM）合并甲状腺功能亢进症（甲亢）患者的临床特点和诊治分析。方法 随访本科2010年7月至2013年9月收治的糖尿病合并甲状腺功能亢进的69例患者,其中男31例,女38例;年龄39～72岁;经过3个月的联合治疗,通过观察患者治疗前后FBG、2h PG、FT3、FT4、TSH等指标的变化来分析其临床特点及治疗方法。结果 对69例合并两种疾病的患者进行联合治疗后,患者心悸、消瘦、多饮、多尿等高代谢症状均得到明显缓解,且各项指标如FBG降至（6.1±1.2）mmol/L、2h PG维持在（7.8±2.5）mmol/L、FT3为（4.4±2.7）pg/L、FT4降至（10.4±4.5）ng/L、TSH恢复到（4.1±1.4）m U/L,甲状腺功能及血糖浓度均优于治疗前,有明显统计学差异（P〈0.05）。其中3例患者在治疗过程中出现低血糖反应,经给予药物减量或停用后低血糖症状纠正。结论 糖尿病与甲状腺功能亢进症的患者在临床表现上可出现重叠现象,且病情两者相互加重,临床上对其进行联合治疗,可获得满意的疗效。

Objective To research and discuss the clinical characteristics and diagnosis analysis of diabeticpatients with hyperthyroidism. Methods A retrospective analysis was conducted on data of 69 cases of diabetesmellitus with hyperthyroidism patients in our Hospital from July 2010 to September 2013. The changes of FBG , 2hPG , FT , FT4 and TSH before and after three months of treatment were observed and its clinical characteristicsits were analyzed. Results After three-month treatment, high metabolism symptoms of patients were alleviatesignificantly. Compared with those before treatment, the levels of FBG , 2hPG , FT3 , FT4 and TSH wereobviously decreased, and the difference was statistically significant（ P 〈0. 05）. Three patients appeared hypoglycemiain the treatment, which was corrected with dosage reduction or discontinuation. Conclusion The clinicalmanifestations of diabetic patients withhyperthyroidismmay overlap and the illness may exacerbate each other,so combined treatment can obtain satisfactory effect.