中文摘要：

目的探讨糖尿病合并格雷夫斯病的临床特点。方法选取2009—2011年在上海交通大学附属第六人民医院内分泌代谢科住院的糖尿病合并格雷夫斯病患者44例，按不同起病时间将患者分为糖尿病先起病组（A组，25例）、格雷夫斯病先起病组（B组，5例）、糖尿病合并格雷夫斯病同时起病组（C组，14例）。对3组患者的一般资料、糖展病分型及腹岛β细胞功能〔空腹C肽（0 min CP）、餐后30 min C肽（30 min CP）、餐后2 h C肽（120 minCP）、餐后2 hC肽与空腹C肽差值（△CP）〕、血糖〔糖化血红蛋白（HbAlc）、糖化血清清蛋白（GA）〕、血脂〔总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）〕、格雷夫斯病症状及体征、甲状腺功能〔游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）〕及甲状腺自身抗体〔促甲状腺素受体抗体（TR-Ab）、抗甲状腺球蛋白抗体（TG-Ab）、抗甲状腺过氧化物酶抗体（TPO-Ab）〕及糖尿病急性并发症、格雷夫斯病并发症等进行回顾性分析比较。结果3组患者的发病年龄、有格雷夫斯病家族史者比例、血TG水平、TG-Ab及TPO-Ab滴度比较，差异均有统计学意义（P〈0.05）;其中C组患者发病年龄、TG水平低于A组及B组，有格雷夫斯病家族史者比例、TG-Ab及TPO-Ab滴度均高于A组及B组，差异有统计学意义（P〈0.05）。3组患者酮症酸中毒及格雷夫斯病并发症发生率比较，差异均无统计学意义（P〉0.05）。结论糖尿病合并格雷夫斯病同时起病者较糖尿病先起病者及格雷夫斯病先起病者表现为年龄更轻、血TG水平更低，有格雷夫斯病家族史者更多，血TG-Ab、 TPO-Ab滴度更高。

英文摘要：

Objective To evaluate the clinical features of diabetes mellitus combined with Graves disease. MethodsA total of 44 hospitalized patients diagnosed as diabetes mellitus combined with Graves disease in Department of Endocrinology andMetabolism of Shanghai Jiaotong University Affiliated Sixth People＇s Hospital from 2009 to 2011 were divided into three groups bythe onset time of each disease： diabetes mellitus onset first （group A, 25 cases）,Graves disease onset first （group B, 5 ca-ses） and simultaneous onset （ Group C, 14 cases） . Retrospective analysis were performed to compare clinical characteristics,classification of diabetes mellitus,islet β cell function,blood glucose,blood lipid [ total cholesterol （ TC ） , triglyceride（TG）,low density lipoprotein （ LDL）,high density lipoprotein （ HDL）〕,symptoms and signs of Graves disease,thyroidfunction,thyroid auto - antibodies〔 thyrotropin receptor antibody （ TR - Ab ）,anti - thyroglobulin antibody （ TG - Ab ）,anti-thyroid peroxidase antibody （TPO - Ab）〕,acute complications of diabetes mellitus as well as complications of Graves diseaseamong groups. Results Comparisons of age of onset,proportion of family history of Graves disease,the level of TG,TG - Aband TPO - Ab titre were significantly different （ P 〈 0. 05 ） ; The age of onset and the level of TG in group C was significantlylower than those in the group A and group B,and group C had significantly higher level of family history of Graves disease,TG - Ab and TPO - Ab titre as compared with group A and group B （ P 〈 0. 05 ） . There was no significant difference in the inci-dence of ketoacidosis and complications of Graves disease among three groups （ P 〉 0. 05 ） . Conclusion Patients with simulta-neous onset of diabetes mellitus and Graves disease present with lower onset age and lower serum TG level and higher level of fami-ly history of Graves disease as well as serum TG - Ab and TPO - Ab.