| 杨 芳,檀增桓,韦志坤,杨 力,王利娟,高 明.碘-131联合胰岛素泵治疗2型糖尿病伴发甲亢的近远期疗效及对骨代谢指标的影响[J].,2020,(7):1368-1372 |
| 碘-131联合胰岛素泵治疗2型糖尿病伴发甲亢的近远期疗效及对骨代谢指标的影响 |
| The Short-term and Long-term Efficacy of 131I Combined with Insulin Pump in the Treatment of Type 2 Diabetes Mellitus with Hyperthyroidism and Its Effect on Bone Metabolism |
| 投稿时间：2019-08-22 修订日期：2019-09-18 |
| DOI：10.13241/j.cnki.pmb.2020.07.037 |
| 中文关键词: 碘-131 胰岛素泵 2型糖尿病 甲亢 骨代谢 甲状腺功能 血糖 |
| 英文关键词: 131I Insulin pump Type 2 diabetes mellitus Hyperthyroidism Bone metabolism Thyroid function Blood sugar |
| 基金项目:河北省卫生和计划生育委员会基金项目（20181668） |
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| 中文摘要: |
| 摘要 目的：探讨碘-131（131I）联合胰岛素泵治疗2型糖尿病（T2DM）伴发甲亢的近远期疗效及对骨代谢指标的影响。方法：选取2016年5月至2018年5月我院收治的T2DM伴发甲亢患者125例为研究对象，按照随机数字表法分为A组（n=42）、B组（n=42）和C组（n=41）。其中A组给予131I联合胰岛素泵治疗，B组给予131I联合二甲双胍治疗，C组给予胰岛素泵联合甲硫咪唑治疗。比较三组患者治疗后近远期的临床疗效、治疗前后血糖指标、甲状腺功能指标、骨代谢指标以及不良反应发生情况。结果：治疗后，A组临床近期、远期疗效总有效率高于B组和C组，复发率低于B组、C组（P<0.05）。治疗后三组患者促甲状腺素（TSH）水平高于治疗前，且A组高于B组，游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）水平低于治疗前，且A组低于B组、C组（P<0.05）。治疗后三组患者空腹血糖（FPG）、餐后2小时血糖（2hPG）和糖化血红蛋白（HbA1c）水平低于治疗前，且A组低于B组、C组（P<0.05）。治疗后三组患者骨钙素（BGP）、降钙素（CT）、I型前胶原N端肽（PINP）、β-胶原降解产物（β-CTX）、磷酸酶（ALP）水平低于治疗前，且A组低于B组、C组（P<0.05）。治疗期间三组患者不良反应发生率比较无统计学差异（P>0.05）。结论：采用131I联合胰岛素泵治疗T2DM伴发甲亢患者安全有效，可改善患者甲状腺功能及骨代谢指标，降低血糖水平。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the short-term and long-term efficacy of Iodine-131(131I )combined with insulin pump in the treatment of type 2 diabetes mellitus (T2DM) with hyperthyroidism and its effect on bone metabolism. Methods: A total of 125 patients with T2DM with hyperthyroidism who were admitted to our hospital from May 2016 to May 2017 were enrolled as the study subjects. They were randomly divided into group A (n=42), group B (n=42) and group C (n=41) according to random number table method. Group A was treated with 131I combined with insulin pump, group B was treated with 131I combined with metformin, and group C was treated with insulin pump combined with methimazole. The short-term and long-term clinical efficacy after treatment, blood glucose indicators, thyroid function indicators, bone metabolism indicators before and after treatment and adverse reactions of the three groups were compared. Results: After treatment, the short-term and long-term clinical efficacy of group A were higher than those of group B and group C, and the recurrence rate was lower than that of group B and group C (P<0.05). Thyroid-stimulating hormone (TSH) levels in three groups after treatment were higher than those before treatment, and those in group A were higher than those in group B. Free triiodothyronine (FT3), free tetraiodothyonine (FT4), total triiodothyronine (TT3), total thyroxine (TT4) levels were lower than those before treatment, and those in group A were lower than those in group B and group C (P<0.05). After treatment, the levels of fasting plasma glucose (FPG), 2 hour postprandial blood glucose (2hPG) and glycated hemoglobin (HbA1c) in the three groups were lower than those before treatment, and those in group A were lower than those in group B and group C(P<0.05). After treatment, the levels of bone gla protein (BGP), calcitonin (CT), amino-terminal propeptide of type I procollagen (PINP), β-C-terminal telopeptide of type I collagen (β-CTX), alkaline phosphatase (ALP) in the three groups were lower than those before treatment, and those in group A were lower than those in group B and group C (P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups during treatment (P>0.05). Conclusion: 131I combined with insulin pump is safe and effective in the treatment of type 2 diabetes mellitus with hyperthyroidism. It can improve thyroid function and bone metabolism indicators, and it can reduce blood glucose level. |
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