慢性阻塞性肺疾病急性加重期患者甲状腺激素肺功能与营养状况的相关性研究

Correlation between thyroid hormone,lung function and nutritional status in patients with acute exacerbation of COPD

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者甲状腺激素、肺功能与营养状况的相关性。方法选取2019年1月—12月于福建医科大学附属厦门弘爱医院就诊的AECOPD患者56例为A组,选取同期来院就诊的慢性阻塞性肺疾病(COPD)稳定期患者56例为B组,选取同期来院体检的健康者56例为C组,对比3组甲状腺激素、肺功能指标、营养指标之间的差异,采用Pearson检验分析AECOPD患者甲状腺激素、肺功能与营养状况的相关性。结果3组血清FT3、FT4水平比较,差异有统计学意义(P<0.05);A组血清FT3、FT4水平显著低于B组、C组(P<0.05),B组血清FT3、FT4水平显著低于C组(P<0.05)。3组MVV、FEV_(1)、FVC、FEV_(1)/FVC水平比较,差异有统计学意义(P<0.05);A组MVV、FEV_(1)、FVC、FEV_(1)/FVC显著低于B组、C组(P<0.05),B组MVV、FEV_(1)、FVC、FEV_(1)/FVC显著低于C组(P<0.05)。3组BMI、IBW、ALB、TLC比较,差异有统计学意义(P<0.05);A组ALB、BMI、IBW、TLC显著低于B组、C组(P<0.05);B组ALB、BMI、IBW、TLC显著低于C组(P<0.05)。AECOPD患者FT3水平与MVV、FEV_(1)、FVC、FEV_(1)/FVC、BMI、IBW、ALB、TLC水平正相关性(r>0,P<0.05);AECOPD患者FSH、FT4水平与MVV、FEV_(1)、FVC、FEV_(1)/FVC、BMI、IBW、ALB、TLC水平无相关性(P>0.05)。结论AECOPD患者的甲状腺激素水平、肺功能指标、营养指标均明显低于稳定期COPD患者及健康人群,三种指标能够反映AECOPD急性加重期的病情严重程度及预后,对临床诊治及预测疾病转归具有指导意义。

Objective Objective to analyze the correlation between thyroid hormone,lung function and nutritional status in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 56 AECOPD patients from January 2019 to December 2019 in our hospital were selected as group A,56 patients with stable COPD who came to our hospital at the same period were selected as group B,and 56 healthy people who came to our hospital for physical examination at the same period were selected as group C.The differences of thyroid hormone,lung function index and nutritional index among the three groups were compared,Pearson test was used to analyze the correlation between thyroid hormone,lung function and nutritional status in patients with AECOPD.Results The levels of serum FT3 and FT4 were significantly different among the three groups(P<0.05);the levels of serum FT3 and FT4 were significantly different among the three groups(P<0.05);the levels of serum FT3 and FT4 in group A were significantly lower than those in group B and group C(P<0.05),and the levels of serum FT3 and FT4 in group B were significantly lower than those in group C(P<0.05).The MVV,FEV_(1),FVC,FEV_(1)/FVC levels of the three groups were significantly different(F=241.856/36.198/301.761/149.329,P<0.05);MVV,FEV_(1),FVC,FEV_(1)/FVC in group A were significantly lower than those in group B and group C(P<0.05),and MVV,FEV_(1),FVC and FEV_(1)/FVC in group B were significantly lower than those in group C(P<0.05).The differences of BMI,IBW,ALB and TLC among the three groups were statistically significant(P<0.05);ALB,BMI,IBW,TLC in group A were significantly lower than those in group B and group C(P<0.05);ALB,BMI,IBW and TLC in group B were significantly lower than those in group C(P<0.05);.FT3 was positively correlated with MVV,FEV_(1),FVC,FEV_(1)/FVC,ALB,TLC BMI and IBW in AECOPD patients(r>0,P<0.05);FSH and FT4 levels in AECOPD patients were not correlated with MVV,FEV_(1),FVC,FEV_(1)/FVC,BMI,IBW,ALB,TLC levels(P>0.05).Conclusion The levels of thyroid hormone,lung function and nutrition in AECOPD patients are significantly lower than those in stable COPD patients and healthy people.The three indexes can reflect the severity and prognosis of AECOPD in acute exacerbation stage,and have guiding significance for clinical diagnosis,treatment and prognosis.