摘要
目的 研究外源性胰岛素单独应用及与二甲双胍联合应用对2型糖尿病合并甲状腺结节患者甲状腺结节的影响.方法 选择2017年1月至2017年12月于郑州大学第一附属医院住院治疗的37例2型糖尿病合并良性甲状腺结节患者为研究对象,将其分为常规组23例和对照组14例.常规组单独应用外源性胰岛素进行治疗,对照组应用外源性胰岛素联合二甲双胍进行治疗,记录并比较两组治疗后6个月甲状腺功能及甲状腺结节的变化情况.结果 治疗前,两组一般资料方面,除年龄外,其余指标比较差异未见统计学意义(P>0.05);两组患者治疗前游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素(TSH)、甲状腺结节体积及甲状腺长度、宽度、高度比较,差异均未见统计学意义(P均>0.05).常规组治疗后胰岛素抵抗指数(HOMA-IR)、TSH、甲状腺结节的高度及甲状腺结节体积与治疗前相比,差异有统计学意义(P<0.05);对照组治疗后与治疗前各项指标相比,除体质指数外,其余指标差异均未见统计学意义(P均>0.05).结论 外源性胰岛素虽对于2型糖尿病合并甲状腺结节患者具有快速治疗作用,但会使患者HOMA-IR、血清TSH水平升高,甲状腺结节体积增大;而采用二甲双胍联合胰岛素的治疗方式不仅具有显著的治疗作用,对患者甲状腺功能及甲状腺体积均未有不良影响.
Objective To study the effects of exogenous insulin alone or in combination with metformin on thyroid nodules in patients with type 2 diabetes mellitus complicated with thyroid nodules.Methods A total of 37 patients with type 2 diabetes mellitus complicated with benign thyroid nodules admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2017 were divided into routine group(23 cases)and control group(14 cases).The routine group was treated with exogenous insulin alone,while the control group was treated with exogenous insulin combined with metformin.The changes of thyroid function and thyroid nodules were recorded and compared 6 months after treatment.Results Before treatment,there was no significant difference in general data between the two groups except the age(P>0.05).There was no significant difference in free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroid nodule volume,thyroid nodule length,width and height before treatment of the two groups(P>0.05).After treatment,homeostasis model assessment-insulin resistance(HOMA-IR),TSH,the height of thyroid nodules and the volume of thyroid nodules in routine group were significantly different from those before treatment(P<0.05).There was no significant difference in control group between preoperative and postoperative indexes(except BMI)(P>0.05).Conclusions Although exogenous insulin has a rapid therapeutic effect on patients with type 2 diabetes mellitus complicated with thyroid nodules,it will increase the levels of HOMA-IR and serum TSH and increase the volume of thyroid nodules.The treatment with metformin combined with insulin not only has a significant therapeutic effect,but also has no adverse effects on the patient's thyroid function and thyroid volume.
作者
何娇
秦贵军
He Jiao;Qin Guijun(Department of Endocrinology and Metabolism,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2019年第13期32-35,共4页
Chinese Journal of Practical Medicine
作者简介
通信作者:秦贵军,Email:hyqingj@zzu.edu.cn
