血清甲状腺激素在慢性阻塞性肺疾病急性加重伴呼吸衰竭患者中变化及临床意义

Changes and Clinical Significance of Serum Thyroid Hormone in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的探讨血清甲状腺激素在慢性阻塞性肺疾病加重伴呼吸衰竭患者中的变化情况及其临床意义。方法选取2015年1月—2016年12月因慢性阻塞性肺疾病急性加重伴有呼吸衰竭于该院呼吸内科进行治疗的患者90例,观察治疗前后血清甲状腺激素水平,其中缓解85例,死亡5例,另外随机选取90名健康人作为对照组,比较3个组别中血清甲状腺激素的表达水平。结果在3组人群血清甲状腺激素水平测定结果比较中,急性发作组的TT_3、PaO_2和FT_3在体内的表达水平分别为(1.08±0.32)nmol/L、(50.9±4.6)mm Hg、(3.87±0.46)pmol/L,明显低于缓解组(1.82±0.42)nmol/L、(74.1±6.5)mm Hg、(4.78±0.47)pmol/L和对照组的健康人群(2.32±0.31)nmol/L、(90.8±8.6)mm Hg、(5.07±0.76)pmol/L,差异有统计学意义(P<0.01);将死亡组与缓解组血清甲状腺激素水平测定结果比较,其中死亡组患者的TT_3、TT_3和FT_3的体内表达含量分别为(0.78±0.15)nmol/L、(79.8±14.8)nmol/L、(2.36±0.89)pmol/L,明显低于好转患者(1.81±0.42)nmol/L、(128.69±30.98)nmol/L、(4.79±0.53)pmol/L,差异有统计学意义(P<0.01)。结论慢性阻塞性肺疾病急性加重合并呼吸衰竭患者甲状腺激素水平降低,随病情好转,甲状腺激素水平有恢复,密切监测COPD患者血清中的甲状腺激素水平对于预测疾病的转归具有积极的意义。

Objective This paper tries to investigate the changes and clinical significance of serum thyroid hormone in patients with chronic obstructive pulmonary disease with respiratory failure. Methods 90 patients with acute exacerbation of chronic obstructive pul-monary disease complicated with respiratory failure from January 2015 to December 2016 treated with respiratory medicine in this hospital were selected. Serum thyroid hormone levels were observed before and after treatment, including 85 cases of remission and 5 cases of death; another 90 cases of healthy people were randomly selected as the control group, and the serum thyroid hormone ex-pression levels of the three groups were compared. Results Among the serum thyroid hormone expression levels of the three groups,the expression levels of TT3, PaO2 and FT3 in the acute group were（1.08±0.32）nmol/L,（50.9±4.6）mm Hg,（3.87±0.46）pmol/L respectively, significantly lower than those in the relieve group of（1.82±0.42）nmol/L,（74.1±6.5）mm Hg,（4.78±0.47）pmol/L and the control group of（2.32±0.31）nmol/L,（90.8±8.6）mm Hg,（5.07±0.76）pmol/L, with significant differences（P〈0.01）; the serum thyroid hormone levels of the death group and the remission group were compared, the TT3, TT4, and FT3 in the death group of patients were（0.78±0.15）nmol/L,（79.8±14.8）nmol/L and（2.36±0.89）pmol/L respectively, which were significantly lower than those in the improved patients of（1.81±0.42）nmol/L,（128.69 ±30.98）nmol/L,（4.79 ±0.53）pmol/L, and the difference was statistically significant（P 〈0.01）. Conclusion Thyroid hormone levels in patients with chronic obstructive pulmonary disease complicated with respiratory failure decreased, with the condition improved and thyroid hormone levels recovered. Closely monitoring the serum levels of thyroid hormones in patients with COPD has a positive significance for predicting the outcome of the disease.