慢性阻塞性肺疾病患者血清甲状腺激素的变化及临床意义

目的探讨慢性阻塞性肺疾病(COPD)患者血清甲状腺激素的变化及临床意义。方法将116例COPD患者根据病情分为急性加重期组72例、稳定期组44例,同时选取医院同期体检健康人40例作为对照组,根据患者血氧分压将急性加重期患者分为轻度缺氧组19例、中度缺氧组32例和重度缺氧组21例,比较各组肺功能指标、甲状腺激素水平。结果急性加重期组FEV1占预计值百分比(FEV1%)、计算第一秒用以呼气容积与用力肺活量比值(FEV1/FVC)水平显著低于稳定期组和对照组,稳定期组FEV1%、FEV1/FVC水平显著低于对照组(P<0.05)。急性加重期组患者血清总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、总四碘甲状腺原氨酸(TT4)、游离四碘甲状腺原氨酸(FT4)水平显著低于稳定期组与对照组,稳定期组血清TT3、FT3、TT4、FT4显著低于对照组(P<0.05),各组血清促甲状腺激素(TSH)比较差异无统计学意义(P>0.05)。重度缺氧组患者血清TT3、FT3、TT4、FT4水平显著低于中度缺氧组与轻度缺氧组,中度缺氧组血清TT3、FT3、TT4、FT4显著低于轻度缺氧组(P<0.05),各组血清TSH比较差异无统计学意义(P>0.05)。结论 COPD患者血清TT3、FT3、TT4、FT4降低,COPD急性加重期患者水平低于稳定期患者,而COPD急性加重期患者缺氧越严重,则血清TT3、FT3、TT4、FT4水平越低。

Objective To investigate the changes in serum thyroid hormone and its clinical significance in patientswith chronic obstructive pulmonary disease（COPD）.Methods 116 cases of COPD patients were selected and dividedinto the acute exacerbation group（72 cases）, stable group（44 cases） and 40 healthy people under physical checkup inthe hospital at the same period were selected as the control group.According to blood oxygen pressure, patients of theacute exacerbation group were divided into mild hypoxia group（19 cases）, moderate hypoxia group （32 cases） and se-vere hypoxia group （21 cases）.Lung function, thyroid hormone levels were compared between these groups.ResultsFEV1 percentage of predicted value （FEV1%）, the first second to calculate the expiratory volume and FVC ratio（FEV1/FVC） of the acute exacerbation group were significantly lower than those of the stable group and controlgroup.FEV1%, FEV1/FVC levels of the stable group were significantly lower than those of the control group（ 〈0.05）.Serum total triiodothyronine three （TT3）, free three triiodothyronine （FT3）, total four triiodothyronine （TT4） andfree four triiodothyronine （FT4） levels of the acute exacerbation group were significantly lower than those of stablegroup and control group.Serum TT3, FT3, TT4 and FT4 of the stable group were significantly lower than those of thecontrol group（ 〈0.05）.Serum thyroid stimulating hormone（TSH） showed no significant difference（ 〉0.05） betweengroups.Serum TT3, FT3, TT4 and FT4 levels of the severe hypoxia group were significantly lower than those of themoderate hypoxia group and mild hypoxia group.Serum TT3, FT3, TT4 and FT4 in moderate hypoxia group were sig-nificantly lower than those of the mild hypoxia group（ 〈0.05） and there was no significant difference in serum TSHbetween each group（ 〉0.05）.Conclusion The serum levels of TT3, FT3, TT4 and FT4 decreased in patients withCOPD.The serum levels of TT3, FT3, TT4 and FT4 of COPD patients with acute exacerbation were lower than thoseof COPD patients in stable phase.The more severe the hypoxia is among COPD patients with acute exacerbation, thelower the levels of serum TT3, FT3, TT4 and FT4 of them.