2型糖尿病合并甲状腺功能异常的临床分析

Clinical analysis of thyroid dysfunction in patients with type 2 diabetes mellitus

目的探讨左旋甲状腺素对2型糖尿病合并亚临床甲减的患者血糖控制的影响。方法本研究选取96例2型糖尿病合并甲状腺功能异常患者作为研究对象,所有患者均具有不同程度的亚临床甲减,并随机进行分组;对照组采取常规口服降糖药或注射胰岛素治疗,观察组在此基础上,采取左旋甲状腺素治疗;对比两组患者的血糖控制效果,根据治疗前后的甲状腺激素(FT_3、FT_4、TSH)改善情况,综合评价患者的疗效。结果观察组临床总有效率为91.67%,对照组临床总有效率为77.08%;观察组临床总有效率显著大于对照组(P<0.05);治疗后,两组患者的FT_3、FT_4水平均有所上升,观察组上升的幅度大于对照组,差异无统计学意义;观察组TSH水平显著低于治疗前水平,与对照组对比,差异有统计学意义(P<0.05)。结论左旋甲状腺素可协同提高2型糖尿病合并亚临床甲减的血糖控制效果,纠正甲状腺激素水平,提高甲状腺功能及改善患者的预后,值得临床推广使用。

Objective To investigate the efficacy of levothyroxine for type2diabetic patients with subclinical hypothyroidism in patients withblood sugar control effects.Methods This study selected96cases of patients with abnormal thyroid function in type2diabetes as the research object,all patients have different degrees of subclinical hypothyroidism,and were randomly grouped;the control group adopted conventional oral hypoglycemicagents or insulin treatment,the observation group on this basis,taking levothyroxine treatment;the effect of blood glucose control comparedto two groups of patients before and after treatment,according to the thyroid hormone(FT3,FT4,TSH)to improve the situation,comprehensiveevaluation of the curative effect of the patients.Results The total efficiency of the observation group was91.67%,control group total effective ratewas77.08%;the total efficiency of the observation group was significantly higher than that of control group(P<0.05);after treatment,the twogroups of patients with FT3and FT4levels were increased,observation group increased greatly than the control group,but no significant difference.There was no significant difference;the TSH level of the observation group was significantly lower than the level before treatment,compared withthe control group,with significant difference(P<0.05).Conclusion Levothyroxine can enhance the effect of blood glucose control in type2diabeticpatients with subclinical hypothyroidism,thyroid hormone levels corrected,improve thyroid function and improve the prognosis of patients,worthyof clinical use.