甲状腺功能、C-反应蛋白及D-二聚体水平与慢性阻塞性肺疾病的关系

Study on the relationship between thyroid dysfunction and severity of chronic obstructive pulmonary disease

目的 :探讨甲状腺功能、C-反应蛋白及D-二聚体对慢性阻塞性肺疾病急性加重期患者病情评估的临床意义。方法 :选取77例慢性阻塞性肺疾病(AECOPD)病人及32例健康体检者作为研究对象。将77例AECOPD患者根据病情轻重分为A、B、C三组。其中A组轻度患者24例、B组中度患者32例、C组重度患者21例作为观察对象。另依据患者有没有呼吸衰竭,将AECOPD患者分为无呼吸衰竭组(53例)和呼吸衰竭组(24例)。采用酶联免疫吸附试验(ELISA)测定各组人群血清甲状腺功能、C-反应蛋白(CRP)及D-二聚体水平。结果 :与对照组相比,A组、B组、C组的T3和FT3显著降低,且A、B、C组病情越严重越低,4组之间存在显著差异性;D-二聚体和CRP的水平显著升高,且A、B、C组病情越严重越高,4组之间存在显著差异性;T4、TSH、FT4四组间差异无统计学意义。此结果与无呼吸衰竭组和呼吸衰竭组甲状腺功能、D-二聚体及CRP水平结果一致。A组肺功能(FEVI/FVC、FEV1)、PaO2水平显著高于B组和(C组),且B组PaO2水平显著高于C组,A组PaCO2水平显著低于B组和C组,且B组也显著低于C组。相关分析显示呼吸衰竭组PaO2水平与T3水平呈现正相关,与CRP和D-二聚体水平呈负相关;而PaCO2水平与T3水平呈现负相关,与CRP和D-二聚体水平呈正相关。结论 :甲状腺功能、C-反应蛋白及D二聚体的水平可作为评估AECOPD病情严重程度的观察指标。

Objective The aim of this study is to investigate the correlation between thyroid dysfunction,C-reactive protein and D-dimer in the assessment of patients with acute exacerbation of chronic obstructive pulmonary disease.Methods Seventyseven patients with chronic obstructive pulmonary disease(AECOPD)and 32 healthy subjects were selected as subjects.77 patients with AECOPD were divided into three groups according to their severity.Among them,24 patients in group A,32 patients in group B,and 21 patients in group C were observed.According to the patient’s presence or absence of respiratory failure,AECOPD patients were divided into non-respiratory failure group(53 cases)and respiratory failure group(24 cases).Serum thyroid function,C-reactive protein(CRP)and D-dimer levels were measured by enzyme-linked immunosorbent assay(ELISA).Results Compared with the control group,T3 and FT3 in group A,group B and group C were significantly lower,and the severity of the disease in group A,B and C was lower,and there was significant difference between the four groups;D-dimer levels and CRP were significantly increased,and the higher the severity of the disease in group A,B and C,the significant difference between the 4 groups;the difference between T4,TSH and FT4 was not statistically significant.Significance.This result was consistent with thyroid function,D-dimer and CRP levels in the non-respiratory failure group and the respiratory failure group.The lung function(FEVI/FVC,FEV1)and PaO2 levels in group A were significantly higher than those in group B and(group C),and the level of PaO2 in group B was significantly higher than that in group C.The level of PaCO2 in group A was significantly lower than that in group B.And group C,and group B was also significantly lower than group C.Correlation analysis showed that PaO2 levels in the respiratory failure group were positively correlated with T3 levels and negatively correlated with CRP and D-dimer levels.PaCO2 levels were negatively correlated with T3 levels and positively correlated with CRP and D-dimer levels.Conclusion The levels of thyroid function,C-reactive protein and D-dimer can be used as indicators for assessing the severity of AECOPD.