高龄男性慢性阻塞性肺疾病患者甲状腺激素的临床观察

Clinical observation of thyroid hormone levels in elderly male patients with chronic obstructive pulmonary disease

目的观察高龄男性慢性阻塞性肺疾病（COPD）患者甲状腺激素水平与肺功能减低的关系。方法纳入我院干部病房2006年1月至2010年2月收治的高龄男性COPD患者195例，常规检查甲状腺功能、肺功能[第1秒用力呼气量（FEV1）、FEV1／FVC（用力肺活量）]，比较甲状腺功能正常患者（正常组）与异常患者（减低组）的肺功能，比较肺功能不同分级程度患者（轻、中、重、极重组）的甲状腺功能。结果195例高龄男性COPD患者甲状腺激素浓度减低组与正常组相比FEV1、FEV1／FVC降低明显[（53．67±5．36）％与（57．49±6．09）％、（59．31±6．36）％与（62．05±4．77）％；t值分别为3．582、2．981，P均〈0．01）]。肺功能分级各组三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）比较差异均有统计学意义（F值分别为1．959、1．873，P均〈0．05），其中轻度组与重度组T3、FT3比较差异均有统计学意义（P均〈0．05），但在其他各组间比较差异均无统计学意义（P均〉0．05）；而甲状腺素（T4）、游离甲状腺素（FT4）、促甲状腺素（TSH）肺功能分级各组比较差异均无统计学意义（P均〉0．05）。结论合并甲状腺激素浓度减低的高龄男性COPD患者与无甲状腺功能障碍者相比肺功能下降明显，且甲状腺激素水平越低，肺功能越差。

Objective To observe the relationship between thyroid hormone levels and reduced pulmonary function in elderly male patients with chronic obstructive pulmonary disease（COPD）. Methods One hundred and ninety-five cases of elderly male patients with COPD hospitalized from Jan 2006 to Feb 2010 were enrolled. Thyroid function and lung function （FEV1 （forced expiratory volume in 1 second）, FEV1/FVC （forced vital capacity） ）were examined routinely. Pulmonary function was compared between normal group （with normal thyroid function）and lower group（ with thyroid hypofunction） ,thyroid function was also compared in patients with different grade levels （ mild, moderate, severe, very severe） of pulmonary function. Results FEV1 and FEV1/FVC in thyroid hypofunction group were significantly decreased compared to the normal group（ t = 3. 582,2. 981, respectively,P 〈 0. 01 ）. There was significant difference on T3, FT3 in patients with different grade levels of pulmonary function （ F = 1. 959,1. 873, respectively, P 〈 0. 05 ）, among them, T3 , FT3 were significantly different between mild group and severe group （ P 〈 0. 05 ）, but there was no significant difference in other groups （ P 〉 0. 05）. T4, FT4 , TSH displayed no significant difference in all groupS （ P 〉 0. 05 ）. Conclusion Pulmonary function decreased obviously in elderly old male patients with COPD combined with thyroid hypofunction, and the lower level of thyroid hormone, the worse of pulmonary function.