糖尿病患者下丘脑-垂体-甲状腺功能临床观察

目的 :观察糖尿病患者下丘脑 垂体 甲状腺功能改变。方法 :检测 5 4例糖尿病患者血糖、甲状腺激素水平及TSH对TRH兴奋试验的反应。结果 :5 4例患者中 2 1例呈低T3血症 ,其中 3例伴有T4水平下降 ,2例伴FT3、FT4下降 ,但T4水平正常。TRH兴奋试验均正常。低T3血症组患者空腹血糖值与基础T3(r=- 0 .5 33,P <0 .0 5 )、基础TSH(r=- 0 .4 88,P <0 .0 5 0 )呈负相关。结论 :糖尿病患者在控制不良或合并严重并发症时呈现低T3综合征 ,但垂体 甲状腺轴的功能正常。检测甲状腺激素水平有助于糖尿病病情及预后的估计。

Function of Hypothalamo- pituitary- thyroid Axis in Diabetes Mellitus Patients

Object: To investigate the change of hy po thalamo-pituitary-thyroid axis function in patients with diabetes. Me thods: Parameters of thyroid related hormones and fasting blood gluco se (FBS) were measured for 54 diabetic patients. Of which, 13 patients were rand omly selected for thyroid releasing hormone (TRH) test to evaluate the response of thyroid stimulating hormone (TSH) to TRH. Result: 21 patients had low level of T3 and simultaneously 3 patients had low level of T4 in serum, and 2 patients had low level of FT3 and FT4 but a normal T4 level in serum. All the investigated patients showed normal response to TRH stimulation. Negative r elationships were found between the FBS and basic T3(r=-0.533,P<0.0 5), basic TSH (r=-0.488,P<0.05) in low T3 group. Conclusi on: Diabetic patients uncontrolled or with critical complication low T3 syndrome, but the function of pituitary-thyroid axis is normal. Our findings sug gest that showed thyroid related hormones can be served as a prognostic factor a nd can be used to estimate the state of the diabetic mellitus.