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中文摘要: 目的 探讨2型糖尿病(T2MD)患者甲状腺功能血清学多指标间的相关性，以及甲状腺激素水平对大血管和微血管病变的影响。方法 回顾性研究2014年12月—2017年12月我院收治的276例2型T2MD患者，以是否患有亚临床甲减作为分组标准，将患者分为单纯2型糖尿病组(T2DM组)147例和2型糖尿病合并亚临床甲减组(T2DM+SCH组)129例，观察比较两组血管并发症发生率、甲状腺激素与血管并发症及生化指标的相关性；多因素logistic回归分析合并亚临床甲减的2型糖尿病患者的血管病变危险因素。结果 (1)微血管病变与病程、TSH和SBP呈正相关(P<0.05)，与TT3、FT4和FT3呈负相关(P<0.05)；(2)大血管病变与病程、年龄、吸烟史、TSH、SBP、UA和LDL-C均呈正相关(P<0.05)；(3)有吸烟史的糖尿病合并亚临床甲减患者大血管病变发生率比非吸烟者增加1.63倍，TSH与合并亚临床甲减的T2DM患者大血管病变和微血管病变均存在相关性。结论 甲状腺激素水平对2型糖尿病患者血管病变存在直接影响，对糖尿病血管并发症具有诊断效能。
中文关键词: 2型糖尿病 亚临床甲状腺功能减退症 血管并发症 诊断效能
Abstract:OBJECTIVE To investigate the correlation between multiple markers of thyroid function serology in patients with type 2 diabetes mellitus (T2MD), and to explore the effects of thyroid hormone levels on macrovascular and microvascular diseases. METHODS Retrospective study was conducted on 276 patients with type 2 T2MD admitted to the target hospital from December 2014 to December 2017. Patients were divided into 147 patients with type 2 diabetes mellitus(T2DM group) and 129 patients with type 2 diabetes mellitus complicated with subclinical hypothyroidism (T2DM+SCH group) with or without subclinical hypothyroidism to observe the incidence of vascular complications, thyroid hormone and vascular complications, biochemical markers; multivariate logistic regression analysis of vascular risk factors in patients with type 2 diabetes mellitus with subclinical hypothyroidism. RESULTS (1) Microvascular lesions were positively correlated with course of disease, TSH and SBP(P<0.05), negatively correlated with TT3, FT4 and FT3(P<0.05). (2)Macrovascular lesions were positively correlated with course of disease, age, smoking history, TSH, SBP, UA and LDL-C(P<0.05). (3)The incidence of macrovascular lesions in diabetic patients with subclinical hypothyroidism due to smoking history was 1.63 times higher than non-smokers(P<0.05). There were correlations between macroangiopathy and microangiopathy in clinical hypothyroidism patients with T2DM. CONCLUSION Thyroid hormone levels had a direct impact on vascular disease in patients with type 2 diabetes, and had diagnostic efficacy for diabetic vascular complications.
keywords: type 2 diabetes mellitus subclinical hypothyroidism vascular complication diagnosis efficacy
文章编号：3201912022 中图分类号：R743 文献标志码：
基金项目:
| 作者 | 单位 |
| 刘 洋① |
| Author Name | Affiliation |
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