老年糖尿病酮症酸中毒患者甲状腺激素水平变化研究

目的探讨老年糖尿病酮症酸中毒（DKA）患者甲状腺激素水平变化，为该类疾病患者的临床治疗提供依据。方法选择老年2型糖尿病患者共175例，分为DKA患者81例（DKA组）和无严重并发症的2型糖尿病患者94例（对照组）。检测两组治疗前后的血清甲状腺激素水平变化并分析。结果治疗前DKA组总三碘甲状腺氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（n）均显著低于对照组，两组游离四碘甲状腺原氨酸（FT3）、促甲状腺素（TSH）比较无统计学差异。DKA组治疗后m、Tr4、Fr4均显著升高，与治疗前相比有统计学差异，FT3和TSH较治疗前无显著差异。DKA组治疗后血清甲状腺激素水平与对照组治疗后相比无统计学差异。结论老年糖尿病合并DKA的患者可出现甲状腺激素水平降低，但常规治疗后恢复，因此应综合考虑，不可盲目加用甲状腺激素进行治疗。

Levels of thyroid hormone in elderly patients with diabetic ketoacidosis

Objective To investigate thyroid hormone levels in elderly patients with diabetic ketoacidosis （DKA）. Methods A total of 175 elderly patients with type 2 diabetes were collected and divided into DKA group （ n = 81 ） and control group （ n = 94）. The patients in control group with type 2 diabetes but without serious complications. Before and after treatment, serum thyroid hormone levels were detected and analyzed. Results Before treatment, TT3, TT4 and FT4 were significantly lower in DKA group than control group, but no significant difference was found in FT3 and TSH levels between the two groups. After treatment, TT3, TY4 and FT4 but not FT3 and TSH in DKA group were significantly increased; and no statistically significant difference was observed in serum thyroid hormone levels between DKA group and control group. Conclusion Thyroid hormone levels may be reduced in elderly patients with DKA, but they can be restored after treatment. Therefore, thyroid hormone treatment is not recommended.