摘要
目的:检测儿童1型糖尿病合并酮症酸中毒(diabetic ketoacidosis,DKA)患儿的血清甲状腺激素水平,探讨游离甲状腺激素在判断1型DKA患儿中病情与预后的作用。方法:选择1型DKA患儿40例,根据2009年儿童DKA诊疗指南将DKA分为轻度组21例,中度组12例与重度组7例,3组都进行了血清TSH、TT_3、TT_4、FT_3和FT_4的检测与对比分析。结果:40例患儿均检出甲状腺功能异常,检出率为100.0%;3组血清TSH、TT_3、TT_4、FT_3和FT_4水平对比无统计学意义(P>0.05)。治疗后儿童1型DKA患儿的血清TSH、TT_3、TT_4、FT_3和FT_4值都明显高于治疗前(P<0.05);治疗前后的血清FT_3和TSH值在中度组与重度组、轻度组与重度组之间对比有明显差异(P<0.05),而在轻度组与中度组之间对比无明显差异(P>0.05)。结论:儿童1型DKA患儿的甲状腺功能异常发生率比较高,血清甲状腺激素水平者均有不同程度下降,测定甲状腺激素的水平对病情评估、判断预后意义重大。
Objective：To detect the serum thyroid hormone levels in children with type 1 diabetic ketoacidosis（DKA） for discuss the roles of serum free thyroid hormones levels for judgment of DKA severity and prognosis. Methods：40 children with type 1 diabetic ketoacidosis were selected in our hospital. All the children were divided into mild group（ n = 21）,moderate group（ n = 12） and severe group（ n = 7） accorded to the 2009 children with DKA treatment guidelines,three groups were given detection and analysis of serum TSH,TT3,TT4,FT3 and FT4. Results： 40 children were with abnormal thyroid function,the detection rate was 100. 0%,there were no statistically significant difference in serum levels of TSH,TT3,TT4,FT3 and FT4 between the three groups（ P〈0. 05）. After the treatment,the serum TSH,TT3,TT4,FT3 and FT4 levels were significantly higher than those before treatment（ P〈0. 05）. Before and after treatment,the serum FT3 and TSH values compared between the moderate group and severe group,mild group and severe group were all significant difference（ P〈0. 05）,but compared between the mild group and moderate group were not significant difference（ P〈0. 05）. Conclusion：The children with type 1 DKA are more with thyroid dysfunction,and the serum thyroid hormone levels are decreased to some extent,the determination of thyroid hormone levels can evaluate the severity of DKA and prognosis.
作者
王怡萍
宋福英
李国红
WANG Yi-ping;SONG Fu-ying;LI Guo-hong(Department of Endocrinology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《川北医学院学报》
CAS
2018年第3期450-453,共4页
Journal of North Sichuan Medical College
关键词
1型糖尿病
酮症酸中毒
甲状腺激素
儿童
Type 1 diabetes mellitus
Diabetic ketoaeidosis
Thyroid hormone
Children
