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目的 探讨Graves病患者糖代谢状况及糖化血红蛋白、胰岛素变化的临床意义。方法 对 86例Graves病患者作口服葡萄糖耐量试验 (OGTT)、胰岛素释放试验、糖化血红蛋白 (GHb)及甲状腺激素水平测定 ,并与正常人组及 2型糖尿病组进行比较。结果 Graves病患者合并糖代谢异常者占 5 5 .8% (30 / 86 +18/ 86 ) ,GHb异常率占 5 4 .6 % ,其中糖耐量低减者占 34.9% ,呈糖尿病样者占 2 0 .9% ,糖尿病样者餐后胰岛素明显升高。经抗甲亢 6个月 1年 ,甲状腺激素恢复正常后 ,糖耐量低减组 93.3%的患者血糖恢复正常 ,83.3%患者的GHb恢复正常 ;糖尿病样组 2 8%的患者血糖恢复正常 ,餐后胰岛素仅 16 .7%恢复正常。结论 Graves病患者应常规作OGTT、GHb检查 ,并定期随访 ,部分患者可进一步查糖负荷后胰岛素及谷氨酸脱羧酶抗体 (GAD -Ab)。
Objective To investigate the clinical significance of glycometabolism and glycosylated hemoglobin (HbA1c) and insulin in patients with Graves disease. Methods The oral glucose tolerance test (OGTT), insulin release test, glycosylated hemoglobin (GHb) and thyroid hormone levels in 86 patients with Graves’ disease were measured and compared with those in normal people and type 2 diabetic patients. Results Graves disease patients with abnormal glucose metabolism accounted for 55.8% (30/86 + 18/86), GHb abnormal rate accounted for 5.4%, of which impaired glucose tolerance accounted for 34.9% of those with diabetes-like 20.9%, diabetic patients with postprandial insulin significantly increased. After 6 months and 1 year of anti-hyperthyroidism, thyroid hormones returned to normal, 93.3% of patients with impaired glucose tolerance returned to normal, and 83.3% of patients returned to normal. Serum glucose returned to normal in 28% of patients with diabetes mellitus, Only 16.7% of insulin returned to normal. Conclusions Patients with Graves disease should be routinely treated with OGTT and GHb and be followed up regularly. Some patients may further check the post-loading insulin and glutamic acid decarboxylase antibody (GAD-Ab).