乙型糖尿病患者甲状腺激素及自身抗体异常的临床分析

目的：通过分析乙型糖尿病患者和健康对照组甲状腺激素及自身抗体的异常情况，探讨乙型糖尿病和甲状腺疾病的关系。方法对396例乙型糖尿病患者及411例健康体检者（对照组）测定其血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平，同时测定其抗甲状腺球蛋白抗体（TGAb）及抗甲状腺过氧化物酶抗体（TPOAb）。结果在健康对照组中，甲状腺激素异常发病率为7．5％，其中男性为5．5％，女性为9．4％，女性亚甲减患病率为4．7％，高于男性亚甲减患病率的1．5％，差异有统计学意义（P ＜0．05）；健康对照组中 TPOAb 阳性率为10．2％，TGAb 阳性率为6．6％。在乙型糖尿病（T2DM）患者中，甲状腺激素异常发病率为16．2％，男性为12．3％，女性为20．5％，其中女性亚甲减患病率为9．2％高于男性4．3％，差异有统计学意义（P ＜0．01），T2DM 患者亚甲减占甲状腺功能异常发生率的40．6％；TPOAb 阳性率为15．2％，TGAb阳性率为7．1％。结论乙型糖尿病患者中甲状腺疾病患病率较健康对照组明显增加，以女性亚甲减为主；对糖尿病患者进行甲状腺自身抗体筛查及定期监测 FT3、FT4、TSH，对糖尿病患者的病情的评估、预后的判断和指导治疗具有重要的临床意义。

Clinical analysis on thyroid hormone and autoantibodies in patients with type 2 diabetes mellitus

Objective To explore the relationship between type 2 diabetes mellitus（T2DM）and thyroid diseases by analyzing the abnormal status of thyroid hormone and antibodies in T2DM patients and the healthy control group.Methods The serum thyroid stimulating hormone （TSH）,free triiodothyronine （FT3）,free thyroxine （FT4）,anti-thyroglobulin antibody （TGAb）and anti -thyroid peroxidase antibody （TPOAb）were measured in 396 patients with T2DM and 411 healthy persons.Results In the healthy group,the incidence rate of abnormal thyroid hormone was 7.5%,in which the male was 5.5% and female was 9.4%,the incidence rate of subclinical hypothyroidism in females was 4.7%,which was higher than 1.5% in males,there was statistically significant difference between them（P 〈0.05）;the positive rate of TPOAb in the healthy control group was 10.2% and the positive rate of TGAb was 6.6%;in T2DM patients,the incidence rate of thyroid hormone abnormalities was 16.2%,which in males and females were 12.3% and 20.5% respectively,among them the incidence rate of subclinical hypothyroidism in females was 9.2%,which was significantly higher than 4.3% in males,the difference had statistical significance （P 〈0.01）,T2DM patients with subclinical hypo-thyroidism accounted for 40.6% of thyroid dysfunction incidence rate;the positive rate of TPOAb was 15.2% and the positive rate of TGAb was 7.1 %.Conclusion The incidence rate of thyroid diseases in T2DM patients is significantly increased compared with the healthy control group,subclinical hypothyroidism in females is predominant;screening thyroid autoantibodies and monitoring FT3,FT4 and TSH at regular intervals in T2DM have the important clinical significance for evaluating the disease condition,jud-ging prognosis and guiding treatment.