论文部分内容阅读
作者研究了19例甲状腺正常的严重糖尿病酮酸中毒病人的垂体甲状腺轴,所有病人在酮酸中毒前甲状腺功能均正常。入院时均有明显酮酸中毒。血糖浓度为375～1730mg%,动脉血pH6.75～7.22,尿糖、尿酮呈强阳性。经24小时胰岛素治疗后,病人均恢复,酮尿消失。入院时所有病人均抽血测T_3、T_4、TSH、T_3树脂吸收值(RT_3U),部分病人作反T_3(rT_3)及TRH试验,并于酮酸中毒之初及纠正后5天分别抽血对照。结果发现:在糖尿病酮酸中毒病人中普遍存在着低T_3综合征,即血清T:浓度减低、rT_3浓度增高、T_4浓度稍减低、RT_3U稍升高、TSH浓度正常,而TSH对TRH刺激呈迟钝反应。这种低T_3综合征在酮酸中毒恢复之初依然存在,在糖尿病酮酸
The authors studied the pituitary thyroid axis in 19 patients with normal thyroid gland in patients with severe diabetic ketoacidosis and all patients had normal thyroid function before ketoacidosis. Significant ketoacidosis on admission. Blood glucose concentration of 375 ~ 1730mg%, arterial pH6.75 ~ 7.22, urine glucose, urine ketone was strongly positive. After 24 hours of insulin treatment, the patient recovered, urine disappeared. T_3, T_4, TSH and T_3 resin absorption (RT_3U) were measured in all patients on admission. Some patients were tested for anti-T_3 (rT_3) and TRH. Blood samples were collected at the beginning of ketoacidosis and 5 days after correction . The results showed that low T_3 syndrome was common in patients with diabetic ketoacidosis, ie, serum T decreased, rT_3 increased, T_4 decreased slightly, RT_3U increased slightly, TSH became normal, and TSH had a slow response to TRH reaction. This low T_3 syndrome persists at the onset of ketoacidosis, in diabetic ketoacids