胰岛素强化治疗对糖尿病患者甲状腺激素及抑郁状态的影响

The effects of intensive insulin therapy on thyroid hormones and depressive state in diabetics

目的研究胰岛素强化治疗对糖尿病患者甲状腺激素及抑郁状态的影响。方法选取我院内科收治的糖尿病患者170例,随机分为观察组(n=85)和对照组(n=85),观察组给予胰岛素强化治疗,对照组给予口服降糖药治疗,检测2组治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)水平及游离甲状腺激素FT3、FT4和促甲状腺激素(TSH)水平,比较BDC抑郁指数改善情况。结果 2组治疗后FPG、2hPG及HbA1c水平均显著下降,差异有统计学意义(P<0.05);治疗前2组抑郁者FT3、FT4水平低于非抑郁者,TSH水平高于非抑郁者,差异有统计学意义(P<0.05);治疗后观察组抑郁患者FT3、FT4水平均显著上升,TSH及抑郁指数水平显著降低,差异有统计学意义(P<0.05)。结论胰岛素强化治疗不仅可控制糖尿病患者血糖,还可改善其甲状腺激素水平及抑郁指数,提示糖尿病患者抑郁症状与甲状腺激素具有一定的相关性。

Objective To study the influences of intensive insulin therapy on thyroid hormones （TH） and depressive state in diabetics. Methods All 170 cases with diabetics in our hospital were randomly divided into study group （n= 85） in which cases received intensive insulin therapy, and control group （n = 85） in which cases took oral hypoglycemic drugs. Fasting blood glucose （FBG）,BG two hours after breakfast （2hFBG）,glycocylated hemoglobin （HbA1c）, free TH3 （FT3）, free T H4 （FT4）and TSH were tested in two groups. And depression index was compared. Results The levels of FBG, 2hFBG and HbAlc were significantly decreased after treatment in both two groups （P〈0.05）. Before treatment, the levels of FT3 and FT4 in depression group were lower than those in non-depression group with statistical differences （P〈0.05）. After treatment,the depression group showed higher levels of FT3 and FT4 as well as lower levels of TSH and depression index （P〈 0.05）. Conclusion Intensive insulin therapy can not only control blood glucose, but improve TSH level and depression index as well, which indicates that depression may be associated with the levels of thyroid hormones. [