甲状腺功能变化对慢性阻塞性肺疾病患者急性加重次数及肺功能减退的影响

Effect of changes in thyroid function on the number of acute exacerbations and lung function decrement in patients with COPD

目的探讨甲状腺功能变化对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者急性加重次数及患者肺功能的影响作用。方法连续性纳入COPD患者80例为COPD组及健康者对照组72例。分别对两组对象检测1 s用力呼气容积(FEV1)、用力肺活量(FVC)以及第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4),总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT4);随诊1年后复测以上指标,并统计COPD患者急性加重次数。结果COPD组FEV1、FVC、FEV1/FVC及TT3、FT3均低于对照组(均P<0.05),两组TT4、FT4、TSH指标差异无统计学意义(均P>0.05);COPD组患者FEV1、FVC、FEV1/FVC、TT3、FT3较1年前均有下降(P<0.05),TT4、FT4、TSH指标较1年前无显著变化(均P>0.05),对照组患者以上各指标较1年前均无明显变化(均P>0.05);COPD组患者TT3、FT3下降值与FEV1、FVC、FEV1/FVC下降值及COPD急性加重次数均呈明显正相关(均P<0.01)。结论COPD患者甲状腺功能有明显变化,T3水平下降与患者肺功能下降及急性加重次数密切相关。

Objective To investigate the effect of thyroid function changes on the number of acute exacer⁃bations and the decrease of lung function in COPD patients.Methods 80 patients with COPD and 72 healthy con⁃trols were included continuously.The forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and the ratio(FEV1/FVC),serum thyroid stimulating hormone(TSH),free triiodothyronogen Amino acid(FT3),free tetraiodothyronine(FT4),total triiodothyronine(TT3),total tetraiodothyronine(TT4)were mea⁃sured for the two groups of subjects;the above indicators were retested after 1 year of follow-up,and the number of acute exacerbations were counted.Results The FEV1,FVC,FEV1/FVC,TT3 and FT3 in the COPD group were significantly lower than those in the control group(all P<0.05).In both the two groups,the indicators of TT4,FT4 and TSH were not significantly different(all P>0.05);FEV1,FVC,FEV1/FVC,TT3,and FT3 in COPD group were lowered compared with that of 1 year ago(P<0.05).TT4,FT4,TSH indicators were not lower than 1 year ago,and these were no significant changes(all P>0.05);FEV1,FVC,FEV1/FVC,TT3,FT3,TT4,FT4,and TSH had no significant changes in patients in the control group compared with 1 year ago(all P>0.05);In COPD group,the decline of TT3 and FT3 has significantly positive correlation with the decline of FEV1,FVC,FEV1/FVC and the number of acute exacerbations of COPD(all P<0.01).Conclusion There were obvious changes about thyroid function in COPD patients.The decrease of T3 level was closely related to the decrease in lung function and the number of acute exacerbations in COPD patients.