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目的分析儿童糖尿病患儿甲状腺功能的改变及其特点。方法 2002年至2010年诊治的初发糖尿病患儿58例,对患儿甲状腺功能结果进行分析。结果 58例患儿中,甲状腺功能正常者33例(56.90%),甲状腺功能异常者25例(43.10%)。异常25例分型:(1)呈甲状腺功能减退(甲减)23例(39.66%),其中单纯低FT3者6例,单纯低FT4者8例,FT3和FT4均减低者2例,亚临床甲减者5例,临床甲减者2例;(2)甲状腺功能亢进2例(3.45%),其中单纯高FT3者1例,FT3和FT4均增高者1例。糖尿病女患儿甲减患病率显著高于男患儿(67.86%vs13.33%,P<0.05)。糖尿病酮症酸中毒患儿甲状腺功能异常发生率显著高于非酮症酸中毒患儿(41.38%vs1.72%,P<0.01)。结论儿童糖尿病在急性代谢紊乱期常有甲状腺激素异常,部分病例需要干预治疗,甲状腺功能检查应做为初发糖尿病患儿常规的检测指标。
Objective To analyze the changes and characteristics of thyroid function in children with diabetes. Methods Fifty-eight cases of newly diagnosed diabetic patients diagnosed and treated from 2002 to 2010 were analyzed for thyroid function. Results Of the 58 children, 33 (56.90%) had normal thyroid function and 25 (43.10%) had hypothyroidism. There were 25 cases with abnormal hypothyroidism (hypothyroidism), 23 cases (39.66%) with hypothyroidism, 6 cases with simple low FT3, 8 cases with simple low FT4, 2 cases with reduced FT3 and FT4, Hypothyroidism in 5 cases, clinical hypothyroidism in 2 cases; (2) hyperthyroidism in 2 cases (3.45%), including high FT3 in 1 case, FT3 and FT4 increased in 1 case. The prevalence of hypothyroidism in diabetic women was significantly higher than that in men (67.86% vs13.33%, P <0.05). The incidence of thyroid dysfunction in children with diabetic ketoacidosis was significantly higher than that in non-ketotic acidosis children (41.38% vs 1.72%, P <0.01). Conclusions Children with diabetes often have abnormalities of thyroid hormone in acute metabolic disorders. In some cases, interventional treatment is required. Thyroid function tests should be used as routine tests in children with primary diabetes.