老年2型糖尿病患者甲状腺激素水平变化的临床意义

Clinical significance of thyroid hormone levels on elderly patients with type 2 diabetes

目的：探讨老年2型糖尿病患者甲状腺激素水平变化及其临床价值。方法选取2013年8月至2014年10月60例老年2型糖尿病患者为观察组，60例正常人为对照组，依据空腹血糖（FBG）水平分为轻、中、重三组，采用放射免疫分析法动态观察甲状腺激素水平，将检测结果进行对比分析。结果与对照组比较，观察组血清游离三碘甲状腺原氨酸（FT3）降低（P 〈0.01），促甲状腺激素（TSH）升高（P 〈0.05），游离甲状腺激素（FT4）比较差异未见统计学意义（P 〉0.05）；与对照组及轻型组比较，中型组与重型组血清 FT3浓度均降低、血清 TSH 浓度升高（P 〈0.01），FT4比较差异未见统计学意义（P 〉0.05）。结论老年2型糖尿病患者 FT3下降、TSH 升高，FT3及 TSH 浓度变化与病情严重程度及预后密切相关，FT3越低或 TSH 浓度越高则病情越重。因此，对老年2型糖尿病患者测定血清 FT3及 TSH 水平，可作为判断病情和预后的生化指标之一。

Objective To investigate the thyroid hormone level changes and its clinical value on elderly patients with type 2 diabetes. Methods Sixty elderly patients with type 2 diabetic from August 2013 to October 2014 were selected as the observation group,60 normal persons were selected as control group. The patients were divided into mild,moderate and severe groups based on the level of fasting＆amp;nbsp;blood glucose. Radioimmunoassay method was used for dynamic observation of thyroid hormone level, and the detect results were compared. Results Compared to the control group,the serum levels of FT3 of the observation group decreased（P 〈 0. 01）and thyroid stimulating hormone（TSH）increased（P 〈0. 05）,the differences of FT4 had no significant difference（P 〉 0. 05）;compared with the control group and the mild group,the serum FT3 of medium group and severe group were lower,and serum TSH con-centration increased（ P 〈 0. 01）,the difference of FT4 had no significant difference（ P 〉 0. 05）. Conclusions In elderly patients with type 2 diabetes,FT3 levels decrease,TSH levels increase,FT3 and TSH concentration change closely with the severity and prognosis,FT3 lower or higher TSH concen-trations are correlated with more severe disease. Therefore,serum FT3 and TSH levels can be used to de-termine the condition and prognosis of elderly patients with type 2 diabetes.