COPD患者甲状腺功能变化的初步探讨

A Preliminary Study of Thyroid Function Changes in COPD Patients

目的探讨慢性阻塞性肺疾病(COPD)患者血清甲状腺激素水平的变化。方法慢性阻塞性肺疾病患者100例为COPD组,根据肺功能分为轻及中度组、重及极重度组;重及极重度组再分为肺心功能代偿组、肺心功能失代偿组。同时选取同期入院的非COPD呼吸道疾病患者为对照组。用酶联免疫吸附法(ELISA)检测各组血清TT3(三碘甲状腺原氨酸)、FT3(游离三碘甲状腺原氨酸)、TT4(甲状腺素)、FT4(游离甲状腺素)、h-TSH(超敏促甲状腺激素)。结果COPD组血清TT3、FT3、TT4、h-TSH表达水平低于对照组(P<0.01);两组FT4比较差异无统计学意义(P>0.05)。重及极重度组的血清TT3、FT3、TT4、h-TSH表达水平低于轻中度组(P<0.01),两组FT4比较差异无统计学意义(P>0.05)。肺心功能失代偿组的血清TT3、FT3、TT4、FT4、h-TSH表达水平低于肺心功能代偿组(P<0.01)。结论COPD患者TT3、FT3、TT4、h-TSH的表达水平随病情严重程度呈递减状态,肺心功能失代偿时FT4也出现明显下降。检测甲状腺激素水平在一定程度上有助于COPD病人病情严重程度的判断。

Objective To investigate the serum thyroid hormone levels change of chronic obstructive pulmonary disease（COPD） patients.Methods 100 with COPD patients were randomly divided into mild to moderate group and severe to extremely severe group according to the pulmonary function.Severe to extremely severe group was further divided into two groups,that was cardio-pulmonary function compensation group,cardio-pulmonary function decompensation group.100 non-COPD patients served as control group who were selected at the same hospitalization period.Of all subjects,5 ml venous blood were taken in the early morning fasting state,and serum TT3（3 triiodothyronine）,FT3（free triiodothyronine 3）,TT4（serum total thyroxine）,FT4（free thyroxine）,h-TSH（ultra-sensitive thyroid stimulating hormone） were detected by enzyme-linked immunosorbent assay（ELISA） .Results Levels of TT3,FT3,TT4,h-TSH of COPD group and the non-COPD was statistical significance（P 0.01）,FT4 was not significant（P 0.05） .Levels of TT3,FT3,TT4,h-TSH of mild to moderate group and severe to extremely severe was statistical significance（P 0.01）,FT4 was not significant（P 0.05） .Levels of TT3,FT3,TT4,FT4,h-TSH of cardio-pulmonary function compensation group and cardio-pulmonary function decompensation group was statistical significance（P 0.01） .Conclusion Levels of TT3,FT3,TT4,h-TSH of COPD patients decreased with the severity of the state,level of FT4 also showed a visible decline when cardio-pulmonary function decompensated.Therefore,the detection of thyroid hormone levels in COPD patients to some extent contribute to the severity of the judge.