老年慢性阻塞性肺病患者疾病严重程度与血清甲状腺素水平的关系

Correlation between thyroxin in serum and clinical extent of disease in elderly patients with COPD

目的探索老年慢性阻塞性肺病（chronicobstructivepulmonarydisease，COPD）患者血清甲状腺素水平与疾病严重程度的关系。方法用放射免疫法测定了49例健康老年人（对照组）和235例老年COPD患者（包括缓解期和急性加重期患者）血清TT3、TT4、FT4、FT3和TSH水平并对数据进行统计学分析。结果与对照组相比，COPD缓解期患者血清甲状腺激素水平无明显差异，而急性加重期患者甲状腺激素水平明显降低（P〈O．05o急性加重期的三组：无肺心病和呼衰组（A组）、有肺心病无呼衰组（B组）、呼衰组（C组），B组和C组的甲状腺激素水平基本上都较A组低，但仅有FT3和TT4有显著性差异（P〈0．05），其中以呼衰组患者最低。另外，FT3水平下降与PaO2下降成正相关。而且COPD死亡组患者除TSH（p〉0．05）外，其余甲状腺激素水平均明显低于存活组（P〈0．05.结论COPD患者存在着明显血清甲状腺激素水平的异常，患者甲状腺激素水平与COPD的严重性、进展和预后有一定关系。

Objective To investigate the correlation between the serum level of thyroxin and clinical extent of disease in elderly patients with COPD. Methods The serum levels of TT3, TT4, FT4, FT3 and TSH were analyzed in 49 elderly volunteers （control group） and 235 elderly patients with COPD （involving remission stage and acute exacerbation） by radioimmunoassay. Results No significant difference in serum thyroxin was shown between patients with COPD at remission stage and volunteers while there was a statistical decrease among patients with acute exacer- bation of C OPD （P 〈 0.05）. After dividing patients with acute exacerbation of COPD into three subgroups： without cor pulmonale and respiratory failure （group A）, only with cor pulmonale （group B）, with respiratory failure （group C）, we found the levels of thyroxin mostly lower in group B and C than group A and the lowest levels of FT3 and TT4 in subgroup with respiratory failure （P〈0.05） as well as the positive correlation between the level of FT3 and PaO2. Besides, the lower levels of thyroxin except TSH were discovered in patients dead of COPD when compared with those who survived （P〈 0.05）. Conclusion The abnormal level of thyroxin in serum can be detected in patients with COPD, which suggests the clinical outcome in elderly patients.