老年慢性阻塞性肺疾病急性加重期甲状腺激素水平及影响因素分析

Analysis of Thyroid Hormone Levels in Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and the Influence Factors

目的探讨慢阻肺急性加重期患者甲状腺功能情况及相关影响因素,为其诊治提供参考。方法选取我院2016年1月-2017年1月住院的COPD急性加重期患者200例作为研究对象,所有患者均询问入院前有无使用激素、吸烟史,入院第二天行血气分析、血甲状腺激素、CRP和空腹血糖检测,病情稳定后行肺功能测定。结果急性加重期COPD患者的甲状腺功能低下占34%,以FT3、TT3减低为主,TT4、FT4无明显改变。FT3和年龄、CRP、FVC呈负相关,和院外有无应用激素呈正相关。TT3和GOLD分级呈负相关,和TT3/TT4、FT3呈正相关。结论 COPD急性加重期患者的甲状腺激素水平低下以FT3、TT3低下为主,且其与年龄、CRP、FVC及有无应用激素有关。

Objective To investigate the thyroid function in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and the related influence factors. Methods 200 patients with AECOPD hospitalized during the period from Jan. 1,2016 to Jan. 1,2017 were enrolled in the study, and all the patients were inquired about the past history of hormone application and smoking at admission; on the second day after admission, blood gas analysis, the detection of serum levels of thyroid hormones, CRP and fasting blood glucose were made to all the patients and pulmonary function test was performed when patients were in stabilized condition. Results 34% patients with AECOPD had hypothyroidism, mainly with the decrease of FT3 and TT3 while no obvious changes were found in TT4 and FT4; FT3 was negatively correlated to age , CRP and FVC while positively to the application of hormone before admission; TT3 was in negative correlation with GOLD grading but in positive correlation with TT3/TT4 and FT3. Conclusions The levels of FT3 and TT3 are low in patients with AECOPD, which is in certain correlation with age, CRP, FVC and the application of hormone.