儿童1型糖尿病合并酮症酸中毒患者血清甲状腺激素水平研究

目的:检测儿童1型糖尿病合并酮症酸中毒(diabetic ketoacidosis,DKA)患儿的血清甲状腺激素水平,探讨游离甲状腺激素在判断1型DKA患儿中病情与预后的作用.方法: 选择1型DKA患儿40例,根据2009年儿童DKA诊疗指南将DKA分为轻度组21例,中度组12例与重度组7例,3组都进行了血清TSH、TT3、TT4、FT3和FT4的检测与对比分析.结果:40例患儿均检出甲状腺功能异常,检出率为100. 0% ;3组血清TSH、TT3、TT4、FT3和FT4水平对比无统计学意义(P＞0. 05).治疗后儿童1型DKA患儿的血清TSH、TT3、TT4、FT3和FT4值都明显高于治疗前(P＜0. 05);治疗前后的血清FT3和TSH值在中度组与重度组、轻度组与重度组之间对比有明显差异(P＜0. 05),而在轻度组与中度组之间对比无明显差异(P＞0. 05).结论: 儿童1型DKA患儿的甲状腺功能异常发生率比较高,血清甲状腺激素水平者均有不同程度下降,测定甲状腺激素的水平对病情评估、判断预后意义重大.

The serum thyroid hormone levels in children with type 1 diabetic ketoaci-dosis

Objective:To detect the serum thyroid hormone levels in children with type 1 diabetic ketoacidosis (DKA) for dis-cuss the roles of serum free thyroid hormones levels for judgment of DKA severity and prognosis. Methods:40 children with type 1 dia-betic ketoacidosis were selected in our hospital. All the children were divided into mild group (n=21),moderate group (n=12) and severe group (n=7) accorded to the 2009 children with DKA treatment guidelines,three groups were given detection and analysis of serum TSH,TT3,TT4,FT3and FT4. Results: 40 children were with abnormal thyroid function,the detection rate was 100. 0% ,there were no statistically significant difference in serum levels of TSH,TT3,TT4,FT3and FT4between the three groups (P＞0. 05). After the treatment,the serum TSH,TT3,TT4,FT3and FT4levels were significantly higher than those before treatment (P＜0. 05). Before and after treatment, the serum FT3and TSH values compared between the moderate group and severe group,mild group and severe group were all significant difference (P＜0. 05),but compared between the mild group and moderate group were not significant difference (P＞0. 05). Conclusion:The children with type 1 DKA are more with thyroid dysfunction,and the serum thyroid hormone levels are decreased to some extent,the determination of thyroid hormone levels can evaluate the severity of DKA and prognosis.