实用医学杂志 ›› 2021, Vol. 37 ›› Issue (16): 2089-2092.doi: 10.3969/j.issn.1006⁃5725.2021.16.011

• 临床研究 • 上一篇    下一篇

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

郑艳文1, 邬海燕1, 胡立红1, 林丽1, 于秀文1 ,陆晓玲2   

  1. 1 杭州市萧山区第一人民医院呼吸科(杭州311200);2 浙江医院呼吸科(杭州310013)

  • 出版日期:2021-08-25 发布日期:2021-08-25
  • 基金资助:
    浙江省医药卫生科技项目(编号:2018KY203);萧山区重大科技攻关项目(编号:2018209);萧山区重大科技攻关政策引导项目(编号:2018305)

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

ZHENG Yanwen*,WU Haiyan,HU Lihong,LIN Li,YU Xiuwen,LU Xiaoling.    

  1. Depart⁃ ment of Respiratory,the First People′s Hospital of Xiaoshan District,Hangzhou 311200,China

  • Online:2021-08-25 Published:2021-08-25

摘要:

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 FEV1、FVC、FEV1/FVC 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 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。

关键词:

慢性阻塞性肺疾病, 甲状腺激素, 1s用力呼气容积, 用力肺活量, 急性加重次数

Abstract:

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.

Key words:

chronic obstructive pulmonary disease, thyroid hormone, forced expiratory volume in the first second, forced vital capacity, number of acute exacerbations