發(fā)布時(shí)間：2018-11-12 08:59

【摘要】：目的:研究2型糖尿病患者的臨床資料,分析2型糖尿病患者中甲狀腺疾病分布情況及患病特點(diǎn),并分析血清生化指標(biāo)在甲狀腺疾病狀態(tài)下的變化情況,尋找其可能的影響因素以利及早進(jìn)行相關(guān)干預(yù)。方法:回顧性查閱2015年-2016年期間在廣西醫(yī)科大學(xué)第一附屬醫(yī)院內(nèi)分泌代謝病科住院的2型糖尿病患者298例,根據(jù)疾病狀態(tài)分為2型糖尿病甲功正常組、甲減組(包含臨床甲減和亞臨床甲減)和甲亢組(包含臨床甲亢和亞臨床甲亢)。以甲功正常組209例患者為對(duì)照組,以89例甲功異�；颊咦鳛椴±M,其中檢測(cè)甲狀腺自身免疫抗體的有218例。收集年齡、病程、血脂、糖化血紅蛋白、甲狀腺自身抗體等指標(biāo),分析以上資料與甲狀腺功能狀態(tài)的相關(guān)性。結(jié)果:本研究共納入298例2型糖尿病患者,其中甲功異常為89/298例,患病率為29.9%,包括甲亢患者42/298例(14.1%),甲減患者47/298例(15.8%),亞臨床甲減、臨床甲減、亞臨床甲亢及臨床甲減患病率分別為11.4%、4.4%、8.7%、5.4%,其中亞臨床甲減組所占比例最大。在本研究的298例患者中,按甲狀腺功能狀態(tài)分為甲功正常組、甲減組、甲亢組,分析結(jié)果示甲減組與甲狀腺功能正常組比較,甲減組的年齡、總膽固醇、TSH均較甲狀腺功能正常組高,甲減組HbA1C、TT3、TT4、FT3、FT4較甲功正常組低,差異均具有統(tǒng)計(jì)學(xué)意義。甲亢組與甲狀腺功能正常組相比,甲亢組總膽固醇、TSH低于甲狀腺功能正常組,TT3、TT4、FT3、FT4均較甲功正常組高,差異具有統(tǒng)計(jì)學(xué)意義。甲狀腺功能異�；颊咧蠺MAb、TGAb、TRAb陽(yáng)性率較甲功正常組有顯著性差異,分別為0.000、0.000、0.007。結(jié)論:1、2型糖尿病患者甲狀腺功能異常的患病率為29.9%,且2型糖尿病患者年齡越大,甲狀腺功能減退患病率增加,建議2型糖尿病患者進(jìn)行甲狀腺疾病篩查,年齡越大者更應(yīng)引起重視。2、在2型糖尿病中,患者機(jī)體處于不同的甲狀腺功能狀態(tài)下時(shí),總膽固醇會(huì)隨之發(fā)生變化,用藥時(shí)應(yīng)注意監(jiān)測(cè)。3、2型糖尿病合并甲減較2型糖尿病甲功正�；颊叩腍bA1C低,建議2型糖尿病合并甲狀腺功能減退的患者更應(yīng)注意監(jiān)測(cè)血糖。4、甲狀腺自身抗體異常的2型糖尿病患者出現(xiàn)甲狀腺功能異常的概率較甲功正常組高,建議目前甲功正常單甲狀腺自身抗體異常的2型糖尿病患者應(yīng)常規(guī)檢測(cè)甲狀腺功能,并定期隨訪。
[Abstract]:Objective: to study the clinical data of type 2 diabetes mellitus, to analyze the distribution and characteristics of thyroid disease in type 2 diabetes mellitus, and to analyze the changes of serum biochemical indexes in thyroid disease. To find its possible influencing factors to facilitate early intervention. Methods: a total of 298 patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrine and Metabolism, first affiliated Hospital of Guangxi Medical University, from 2015 to 2016, were divided into normal type 2 diabetic group according to their disease status. Hypothyroidism group (including clinical hypothyroidism and subclinical hypothyroidism) and hyperthyroidism group (including clinical hyperthyroidism and subclinical hyperthyroidism). 209 cases of normal thyroid function group were taken as control group and 89 cases of thyroid dysthyroidism group as case group. 218 cases of thyroid autoimmune antibody were detected. Age, course of disease, blood lipid, glycosylated hemoglobin and thyroid autoantibodies were collected to analyze the correlation between the above data and thyroid function. Results: a total of 298 patients with type 2 diabetes were included in this study. Among them, there were 89 / 298 cases of dysthyroidism and 29.9% of the total prevalence rate, including 42 / 298 cases (14.1%) of hyperthyroidism and 47 / 298 cases (15.8%) of hypothyroidism. The prevalence rates of subclinical hypothyroidism, subclinical hyperthyroidism and clinical hypothyroidism were 11.44.4and 8.7and 5.4respectively, among which the subclinical hypothyroidism group accounted for the largest proportion. According to thyroid function, 298 patients were divided into normal thyroid function group, hypothyroidism group and hyperthyroidism group. The results showed that the age, total cholesterol of hypothyroidism group were higher than that of normal thyroid function group. TSH was higher than normal thyroid function group, and HbA1C,TT3,TT4,FT3,FT4 in hypothyroidism group was lower than that in normal thyroid function group, the difference was statistically significant. The total cholesterol and TSH of hyperthyroidism group were lower than that of normal thyroid function group, and the TT3,TT4,FT3,FT4 of hyperthyroidism group was higher than that of normal thyroid function group, the difference was statistically significant. The positive rate of TMAb,TGAb,TRAb in the patients with abnormal thyroid function was significantly higher than that in the normal thyroid function group (0.0000.0000.000,0.007). Conclusion: 1 the prevalence of thyroid dysfunction in patients with type 2 diabetes mellitus is 29.9. the older type 2 diabetes patients are, the higher the prevalence of hypothyroidism is. It is suggested that type 2 diabetes patients should be screened for thyroid diseases. The older you get, the more important it is. 2. In type 2 diabetes, when the body is in a different thyroid function, the total cholesterol changes. The HbA1C of patients with type 3 diabetes mellitus with hypothyroidism was lower than that of patients with normal hypothyroidism of type 2 diabetes, and it was suggested that patients with type 2 diabetes mellitus with hypothyroidism should pay more attention to monitoring blood glucose. Type 2 diabetic patients with abnormal thyroid autoantibodies were more likely to have thyroid dysfunction than those with normal thyroid function. It was suggested that type 2 diabetes patients with normal thyroid autoantibodies should be routinely tested for thyroid function. The patients were followed up regularly.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1;R581

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蔣秋明;張熙洋;雷蕾;;糖尿病患者血清促甲狀腺素水平與HbA_1c和疾病類型的關(guān)系[J];山東醫(yī)藥;2016年25期

2 魏合鳳;;56例T2DM合并甲狀腺疾病的患病情況及臨床意義[J];世界最新醫(yī)學(xué)信息文摘;2016年47期

3 欣冰;郭雯;李杰;王亞梅;陳曉倩;上官海燕;;老年2型糖尿病患者甲狀腺激素水平與胰島素抵抗的關(guān)系[J];醫(yī)學(xué)研究生學(xué)報(bào);2015年01期

4 丁麗萍;白蘇榮;李雪梅;卓林;丁美;徐春;楊麗麗;;不同甲狀腺功能狀況下2型糖尿病患者的臨床特征研究[J];陜西醫(yī)學(xué)雜志;2014年12期

5 張冬梅;張莉;鄭瑩瑩;曾怡;廖嵐;雷閩湘;;亞臨床甲狀腺功能減退與2型糖尿病慢性并發(fā)癥的關(guān)系[J];中國(guó)糖尿病雜志;2014年01期

6 石海燕;李忠昌;;2型糖尿病患者中亞臨床甲狀腺功能減退癥與糖尿病血管并發(fā)癥關(guān)系的探討[J];環(huán)球中醫(yī)藥;2013年S2期

7 任春久;張瑤;崔為正;牟志美;;氧化應(yīng)激在2型糖尿病發(fā)病機(jī)制中的作用研究進(jìn)展[J];生理學(xué)報(bào);2013年06期

8 鄭海蘭;沈明;江瀾;李凡;張炯;葉山東;任安;;糖尿病患者合并亞臨床甲狀腺功能減退癥及其血糖控制情況分析[J];國(guó)際病理科學(xué)與臨床雜志;2012年06期

9 肖芳;宋君;陳麗;;脂毒性與胰島微血管內(nèi)皮細(xì)胞損傷的研究進(jìn)展[J];基礎(chǔ)醫(yī)學(xué)與臨床;2012年10期

10 沈艷軍;畢會(huì)民;;亞臨床甲狀腺功能減退對(duì)2型糖尿病慢性并發(fā)癥的影響[J];武漢大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2012年03期

相關(guān)博士學(xué)位論文 前3條

1 方家追;2型糖尿病住院原因和慢性并發(fā)癥患病率及其危險(xiǎn)因素分析[D];浙江大學(xué);2015年

2 邵珊珊;脂毒性致甲狀腺功能異常的機(jī)制研究[D];山東大學(xué);2015年

3 沈曉霞;高糖毒性對(duì)胰島α細(xì)胞分泌功能的影響及其機(jī)制探討[D];中國(guó)協(xié)和醫(yī)科大學(xué);2009年

相關(guān)碩士學(xué)位論文 前2條

1 岳曉菲;2型糖尿病合并甲狀腺功能減退的流行狀況和相關(guān)因素研究[D];天津醫(yī)科大學(xué);2014年

2 姜鶴;2型糖尿病患者甲狀腺疾病伴隨情況的研究[D];大連醫(yī)科大學(xué);2013年

，

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