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目的探讨131Ⅰ联合行为疗法在甲状腺功能亢进(甲亢)合并2型糖尿病临床治疗中的应用价值。方法选取2013年1月—2014年6月收治的甲亢合并2型糖尿病患者98例,随机分为对照组和观察组各49例。两组患者根据自身糖尿病病情接受相应的降糖或胰岛素注射治疗。对照组患者选择口服药物治疗方式,甲硫咪唑30 mg/d,2~3次/d,口服。观察组行131I联合行为疗法,采用口服方式,剂量依据每克甲状腺131Ⅰ剂量(MBp)×甲状腺质量(g)/甲状腺24 h131I摄入率计算。分别于治疗前与治疗后1~3 d进行血糖及甲状腺激素水平测定,观察指标为FPG、2h PG、FT3、FT4,并于治疗后2、4、6个月进行随访调查患者甲状腺功能,与治疗后甲状腺激素水平比较。结果治疗后,对照组FPG、2h PG、FT3、FT4分别为(6.88±1.94)、(10.12±3.58)mmol/L、(6.33±2.65)、(2.57±1.09)ng/L,观察组分别为(6.70±2.03)、(8.51±3.11)mmol/L、(3.20±1.05)、(1.33±0.71)ng/L,两组比较差异均有统计学意义(均P<0.05)。对照组甲状腺功能降低、甲亢复发发生率分别为18.4%、16.3%,观察组分别为2.04%、2.04%,两组比较差异均有统计学意义(均P<0.05)。结论采用131I联合行为疗法治疗甲亢合并2型糖尿病具有较好的临床效果,能够有效控制患者血糖及甲状腺激素水平,复发率较低,明显较常规疗法具有优势。
Objective To investigate the clinical value of 131 Ⅰ combined with behavioral therapy in the treatment of hyperthyroidism (Hyperthyroidism) and type 2 diabetes mellitus. Methods A total of 98 patients with hyperthyroidism and type 2 diabetes who were admitted from January 2013 to June 2014 were randomly divided into control group and observation group of 49 cases. Two groups of patients according to their own diabetes to accept the corresponding hypoglycemic or insulin injection therapy. Control group patients choose oral medication, methimazole 30 mg / d, 2 to 3 times / d, orally. Observation group 131I combined with behavioral therapy, the oral approach, the dose based on thyroid 131I dose per gram of thyroid (g) / thyroid 24h131I intake rate calculation. Blood glucose and thyroid hormone levels were measured before treatment and 1 ~ 3 days after treatment. FPG, 2h PG, FT3 and FT4 were observed. Thyroid function was examined at 2, 4 and 6 months after treatment. Thyroid hormone levels after treatment compared. Results After treatment, the levels of FPG, 2h PG, FT3 and FT4 in the control group were (6.88 ± 1.94), (10.12 ± 3.58) mmol / L, (6.33 ± 2.65) and (2.57 ± 1.09) ng / (6.70 ± 2.03), (8.51 ± 3.11) mmol / L, (3.20 ± 1.05) and (1.33 ± 0.71) ng / L respectively. There was significant difference between the two groups (all P <0.05). The incidences of thyroid dysfunction and recurrence of hyperthyroidism in the control group were 18.4% and 16.3%, respectively, and those in the observation group were 2.04% and 2.04% respectively. There was significant difference between the two groups (all P <0.05). Conclusion 131I combined with behavioral therapy for hyperthyroidism with type 2 diabetes has a good clinical effect, which can effectively control the blood glucose and thyroid hormone levels in patients with a low recurrence rate, which is obviously superior to conventional therapy.