摘要
目的:探讨新诊断需胰岛素治疗的糖尿病(DM)患者甲状腺自身免疫的特点。方法:将新诊断的需胰岛素治疗的DM患者,按是否伴Graves病、慢性淋巴细胞性甲状腺炎、特发性甲状腺功能减退(甲减)及高滴度甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TGAb)比值阳性,分为甲状腺自身免疫异常(TAI)组及非甲状腺自身免疫异常(NTAI)组,由同一内分泌专科医生诊断并随访。分别在入院时、诊断DM后3个月、12个月及24个月检测所有患者的谷氨酸脱羧酶抗体(GADAb)、TPOAb及TGAb、口服葡萄糖耐量试验(OGTT)及C肽释放试验(CPRT)、甲状腺功能(FT3、FT4、TSH)。结果:(1)新诊断的需胰岛素治疗的DM患者中,甲状腺自身免疫异常总的发生率为21.35%,甲状腺功能异常总的发生率为16.85%。(2)TAI组GADAb阳性率高于NTAI组。(3)诊断DM后的3个月内2组患者之间的C肽水平及HbA1c差异无统计学意义,但12个月及24个月后差异有统计学意义。结论:新诊断的需胰岛素治疗的DM中,TAI及甲状腺功能异常的发生率较高,伴TAI者易发生β细胞功能损害。
Objective： To study the change and clinical significance of autoimmune thyroid disease in newly diagnosed insulin-dependent diabetic patients. Methods： The newly diagnosed insulin-dependent diabetic patients were selected to serve as study subjects. They were divided into TAI group and NTAI group according to with or without Graves disease, chron- ic lymphocytic thyroiditis, primary hypothyroidism and high concentration of TPOAb/TGAb. The patients were diagnosed and followed up by the same endocrinologist. The values of GADAb, TPOAb, TGAb, OGTI＇, CPRT, FT3, FT4 and TSH were tested after hospital admission, 3 months, 12 months, and 24 months, after diabetes mellitus （DM） was diagnosed, respectively. Re- suits： The total incidence of TAI in these patients was 21.35% and the incidence of thyroid dysfunction was 16.85%. The pos- itive rate of GADAb in TAI group was higher than that in NTAI group. There were no difference in concentration of C-peptide and the level of HbAtc between TAI group and NTAI group in 3 months after DM diagnosis, but there were significance differ- ences for all tested levels in 12 and 24 months after DM diagnosed, respectively. Conclusion： There were high incidence rates of TAI and thyroid dysfunction in newly diagnosed insulin-dependent diabetic patients. It was found that β-cell dysfunction was prone to occur in these patients with TAI.
出处
《天津医药》
CAS
北大核心
2009年第1期21-23,共3页
Tianjin Medical Journal
关键词
糖尿病
甲状腺
自身免疫
C肽
diabetes mellitus thyroid gland autoimmunity C-peptide
