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目的 :探讨无甲状腺疾病病史的老年慢性阻塞性肺病 (COPD)急性加重期、稳定期与甲状腺功能关系。方法 :使用放免法测定住院 86例老年慢性阻塞性肺疾病 (COPD)患者急性加重期、稳定期及 38例老年正常对照者血清三碘甲状腺原氨酸 (T3)、甲状腺素 (T4 )、促甲状腺素 (TSH)、血清三碘游离甲状腺素 (FT3)和游离甲状腺素 (FT4 )水平。同步检测动脉血中二氧化碳分压 (Pa CO2 )和氧分压 (Pa O2 )。结果 :老年 COPD急性加重期 T3、FT3水平显著低于稳定期及对照组 (P<0 .0 1 ) ,T4 、FT4水平低于稳定期及对照组 (P<0 .0 5 ) ;重度 COPD死亡组 T3、T4 、FT3及 FT4 水平显著低于稳定期组、对照组 (P<0 .0 1 ) ;血清T3、T4 水平与 Pa O2 呈正相关 ,T3水平与 Pa CO2 呈负相关 ;TSH在各组中变化无统计学意义。结论 :老年 COPD呼衰可导致体内甲状腺素水平变化 ,并随病情急性加重 T3、T4 水平显著降低 ,随病情稳定而逐渐改善 ,反复感染、缺氧及二氧化碳潴留是导致老年慢性阻塞性肺病患者合并甲状腺功能正常综合征 (ESS)重要原因 ,ESS是继发的、短暂的、可逆的。在一定程度上反映病情严重程度及预后
Objective: To investigate the relationship between thyroid function and acute exacerbation of elderly patients with chronic obstructive pulmonary disease (COPD) without a history of thyroid disease. Methods: The levels of serum triiodothyronine (T3), thyroxine (T4) and urinary levels of thyroid hormone (T4) in 86 elderly patients with chronic obstructive pulmonary disease (COPD) Thyroxine (TSH), serum triiodothyronine (FT3) and free thyroxine (FT4). Simultaneous detection of arterial partial pressure of carbon dioxide (Pa CO2) and partial pressure of oxygen (Pa O2). Results: The levels of T3 and FT3 in elderly patients with acute exacerbation of COPD were significantly lower than those in stable and control groups (P <0.01), T4 and FT4 levels were lower than those in stable and control groups (P <0.05), severe COPD The levels of T3, T4, FT3 and FT4 in the death group were significantly lower than those in the stable group and the control group (P <0.01). The serum levels of T3 and T4 were positively correlated with the PaO2 and the T3 levels were negatively correlated with the PaCO2. There was no significant change in each group. Conclusion: Elderly patients with chronic respiratory distress syndrome (COPD) can lead to the change of thyroid hormones in the body. With the acute exacerbation of T3 and T4, the levels of T3 and T4 are significantly decreased. With the stable condition, the levels of thyroxine change gradually. Repeated infection, hypoxia and carbon dioxide retention are the causes of elderly COPD Essential thyroid function syndrome (ESS), ESS is secondary, transient, reversible. To a certain extent, reflect the severity and prognosis