2型糖尿病患者亚临床甲状腺功能减退症与血管并发症的相关性分析

发布时间：2018-06-18 08:13

本文选题：2型糖尿病 + 亚临床甲减　；参考：《青海大学》2017年硕士论文

【摘要】：目的:本研究旨在通过探讨2型糖尿病(T2DM)合并亚临床甲状腺功能减退症(SCH)病患的临床特征以及分析其与DM血管并发症之间的关系,以期能为T2DM血管并发症的早期预防及治疗工作提供一定的参考依据和新的方向。方法:1)收集青海大学附属医院内分泌科2015年11月-2016年11月期间住院接受治疗且临床资料较为完善的T2DM病患200例,按照SCH诊断标准,将合并有SCH的97例作为T2DM合并SCH组,甲功正常的103例作为单纯T2DM组。2)记录病患的一般资料及生化检验指标,颈动脉内膜中层厚度(CMIT)、ABI,所有病患请有经验的眼科医师会诊进行眼底检查。3)分析比较两组病患的一般资料及临床资料,总结T2DM合并SCH病患的临床特征,并分析上述指标对DM血管并发症的影响。应用SPSS21.0系统软件对数据部分进行统计学处理及分析。结果:1.T2DM合并SCH组的TC、TG、24h尿蛋白、ACR、TSH水平高于单纯T2DM组;Hb A1c、FT3、FT4水平低于单纯T2DM组(P0.05)。2.合并SCH组与单纯T2DM组比较:糖尿病肾病(DN)、颈动脉粥样硬化(CAS)及下肢外周动脉病变(PAD)的发生率高于单纯T2DM组,差异有统计学意义(P0.05);而糖尿病视网膜病变(DR)的发生率在其两组间无明显差别。3.在分别进行二元Logistic回归分析后发现SCH是DN、CAS以及PAD的危险因素。结论:SCH在T2DM病患中发病率较高,其在不同程度上影响了病患的糖代谢及脂代谢,并且作为T2DM病患DN、CAS及PAD等血管并发症的危险因素而存在。
[Abstract]:Objective: to investigate the clinical features of patients with type 2 diabetes mellitus (T2DM) complicated with subclinical hypothyroidism (Sch) and to analyze its relationship with vascular complications of DM. In order to provide some reference and new direction for early prevention and treatment of vascular complications in type 2 DM. Methods: a total of 200 patients with T2DM were collected from Department of Endocrinology, affiliated Hospital of Qinghai University, from November 2015 to November 2016. According to SCH diagnostic criteria, 97 cases with SCH were selected as T2DM combined with SCH group. 103 cases with normal thyroid function were used as simple T2DM group. 2) to record the general data and biochemical test indexes of the patients. All patients were consulted by experienced ophthalmologist for fundus examination. 3) the general data and clinical data of the two groups were analyzed and compared, and the clinical features of patients with T2DM complicated with Sch were summarized. The effect of the above indexes on the vascular complications of DM was analyzed. SPSS 2 1.0 system software was used to process and analyze the data. Results 1. The levels of TCU TGN 24 h urinary protein TSH in T2DM combined with Sch group were higher than those in T2DM group and T2DM group. The level of FT3FT4 in T2DM group was lower than that in T2DM group. Compared with simple T2DM group, the incidence of diabetic nephropathy, carotid atherosclerosis (CAS) and peripheral artery disease of lower extremity (PAD) in SCH group was higher than that in simple T2DM group. The difference was statistically significant (P 0.05), but the incidence of diabetic retinopathy was not significantly different between the two groups. After binary logistic regression analysis, SCH was found to be a risk factor for DNN CAS and pad. Conclusion the incidence of the disease is higher in T2DM patients. It affects glucose metabolism and lipid metabolism in T2DM patients, and is a risk factor for vascular complications such as DNN, CAS and pad in T2DM patients.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R581.2

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