甲亢合并糖尿病的临床治疗观察

Observation of clinical treatment for hyperthyroidism complicated with diabetes

目的探讨甲亢合并糖尿病的临床治疗方式和效果。方法 51例经临床确诊为甲亢合并糖尿病患者,在治疗过程中使用甲疏咪唑联合瑞格列奈和胰岛素注射的方式,分别记录治疗前后患者血糖和甲状腺指标变化。结果 1 51例患者甲状腺功能:治疗后血清游离三碘甲状腺原氨酸水平(4.48±0.87)ng/L明显低于治疗前(14.49±7.28)ng/L,差异具有统计学意义(P<0.05);治疗后血清游离甲状腺激素水平(7.48±1.19)ng/L明显低于治疗前(49.37±13.48)ng/L,差异具有统计学意义(P<0.05);治疗后促甲状腺激素水平(3.87±0.52)m U/L明显高于治疗前(0.03±0.01)m U/L,差异具有统计学意义(P<0.05)。2 51例患者血糖:治疗后空腹血糖值(6.28±0.81)mmol/L明显低于治疗前(12.47±2.19)mmol/L,差异具有统计学意义(P<0.05);治疗后餐后2 h血糖值(7.28±1.83)mmol/L明显低于治疗前(18.96±4.33)mmol/L,差异具有统计学意义(P<0.05)。结论治疗甲亢合并糖尿病时必须对两种疾病均开展治疗,调整血糖和甲状腺功能指标,从而保证治疗效果。

Objective To investigate clinical treatment method and effect for hyperthyroidism complicated with diabetes. Methods A total of 51 patients with diagnosed hyperthyroidism complicated with diabetes all received methimazole combined with repaglinide and insulin injection during treatment. Changes in blood glucose and thyroid indexes before and after treatment were recorded. Results① Thyroid function in 51 patients： their serum free triiodothyronine level after treatment was obviously lower as（4.48±0.87） ng/L than（14.49±7.28） ng/L before treatment, and the difference had statistical significance（P〈0.05）. After treatment, the thyrotropic hormone level was much higher as（3.87±0.52） m U/L than（0.03±0.01） m U/L before treatment, and the difference had statistical significance（P〈0.05）. ② Blood glucose in 51 patietns： their fasting blood glucose after treatment was obviously lower as（6.28±0.81） mmol/L than（12.47±2.19） mmol/L before treatment, and the difference had statistical significance（P〈0.05）. After treatment, the 2 h postprandial blood glucose was much lower as（7.28±1.83） mmol/L than（18.96±4.33） mmol/L before treatment, and their difference had statistical significance（P〈0.05）. Conclusion Hyperthyroidism complicated with diabetes requires simultaneous treatment for the two diseases, with blood glucose and thyroid function indexes adjustment to guarantee curative effect.