CAJ | 학술논문

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。
목적：통과분석을형당뇨병환자화건강대조조갑상선격소급자신항체적이상정황，탐토을형당뇨병화갑상선질병적관계。방법대396례을형당뇨병환자급411례건강체검자（대조조）측정기혈청촉갑상선격소（TSH）、유리삼전갑상선원안산（FT3）、유리갑상선소（FT4）수평，동시측정기항갑상선구단백항체（TGAb）급항갑상선과양화물매항체（TPOAb）。결과재건강대조조중，갑상선격소이상발병솔위7．5％，기중남성위5．5％，녀성위9．4％，녀성아갑감환병솔위4．7％，고우남성아갑감환병솔적1．5％，차이유통계학의의（P ＜0．05）；건강대조조중 TPOAb 양성솔위10．2％，TGAb 양성솔위6．6％。재을형당뇨병（T2DM）환자중，갑상선격소이상발병솔위16．2％，남성위12．3％，녀성위20．5％，기중녀성아갑감환병솔위9．2％고우남성4．3％，차이유통계학의의（P ＜0．01），T2DM 환자아갑감점갑상선공능이상발생솔적40．6％；TPOAb 양성솔위15．2％，TGAb양성솔위7．1％。결론을형당뇨병환자중갑상선질병환병솔교건강대조조명현증가，이녀성아갑감위주；대당뇨병환자진행갑상선자신항체사사급정기감측 FT3、FT4、TSH，대당뇨병환자적병정적평고、예후적판단화지도치료구유중요적림상의의。
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.