中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
3期
267-270
,共4页
目的 分析老年慢性阻塞性肺疾病急性加重期(AECOPD)患者或合并呼吸衰竭治疗前后甲状腺激素变化特点,探讨其临床意义.方法 选择老年AECOPD患者40例,测定其治疗前、后及合并呼吸衰竭时甲状腺激素浓度；另选择与之年龄匹配的健康体检者40名,同期测定其甲状腺激素浓度作为对照比较.结果 老年AECOPD患者血清三碘甲状腺原氨酸(T3)、血清游离三碘甲状腺原氨酸(FT3)、血清甲状腺素(T4)、血清游离甲状腺素(FT4)显著低于对照组:T3[(1.23±0.25) nmol/L与(1.70±0.29) nmol/L,t=3.97,P＜0.01]、FT3[(3.27±0.59) pmol/L与(4.48±0.95) pmol/L,t =6.09,P＜0.01]、T4[( 109.30±17.73) nmol/L与(116.01±18.72) nmol/L,t =6.94,P ＜0.01]、FT4[ (15.11 ±2.37)pmol/L与( 17.62±0.35) pmol/L,t=7.23,P＜0.01]；老年AECOPD合并呼吸衰竭者T3,FT3,T4,FT4低于未合并者:T3[ (1.08±0.10) nmol/L与(1.35±0.26) nmol/L,t=4.02,P＜0.01]、FT3[(2.89±0.41)pmol/L与(3.59±0.53) pmol/L,t=4.58,P＜0.01]、T4[(96.54±14.34) nmol/L与(115.20±26.10)nmol/L,t =2.71,P＜0.01]、FT4[(14.05±2.05) pmol/L与(17.11±1.55) pmol/L,t =5.37,P＜0.01];老年AECOPD患者治疗后T3、FT3、T4浓度较治疗前升高,T3[(1.43±0.29) nmol/L与(1.25±0.25)nmol/L,t =2.93,P＜0.01]、FT3[ (3.61±0.49) pmol/L与(3.26±0.60)pmol/L,t=2.73,P＜0.01]、T4[(114.31±10:99) nmol/L与(110.28±16.91) nmol/L,t =4.58,P<0.01].结论 老年AECOPD患者T3、FT3、T4、FT4浓度降低；合并呼吸衰竭患者下降更为明显；积极治疗可提高甲状腺激素浓度,从而改善病情.甲状腺激素浓度的变化对老年AECOPD患者病情判断、疗效分析、预后估计有一定临床意义.
目的 分析老年慢性阻塞性肺疾病急性加重期(AECOPD)患者或閤併呼吸衰竭治療前後甲狀腺激素變化特點,探討其臨床意義.方法 選擇老年AECOPD患者40例,測定其治療前、後及閤併呼吸衰竭時甲狀腺激素濃度；另選擇與之年齡匹配的健康體檢者40名,同期測定其甲狀腺激素濃度作為對照比較.結果 老年AECOPD患者血清三碘甲狀腺原氨痠(T3)、血清遊離三碘甲狀腺原氨痠(FT3)、血清甲狀腺素(T4)、血清遊離甲狀腺素(FT4)顯著低于對照組:T3[(1.23±0.25) nmol/L與(1.70±0.29) nmol/L,t=3.97,P＜0.01]、FT3[(3.27±0.59) pmol/L與(4.48±0.95) pmol/L,t =6.09,P＜0.01]、T4[( 109.30±17.73) nmol/L與(116.01±18.72) nmol/L,t =6.94,P ＜0.01]、FT4[ (15.11 ±2.37)pmol/L與( 17.62±0.35) pmol/L,t=7.23,P＜0.01]；老年AECOPD閤併呼吸衰竭者T3,FT3,T4,FT4低于未閤併者:T3[ (1.08±0.10) nmol/L與(1.35±0.26) nmol/L,t=4.02,P＜0.01]、FT3[(2.89±0.41)pmol/L與(3.59±0.53) pmol/L,t=4.58,P＜0.01]、T4[(96.54±14.34) nmol/L與(115.20±26.10)nmol/L,t =2.71,P＜0.01]、FT4[(14.05±2.05) pmol/L與(17.11±1.55) pmol/L,t =5.37,P＜0.01];老年AECOPD患者治療後T3、FT3、T4濃度較治療前升高,T3[(1.43±0.29) nmol/L與(1.25±0.25)nmol/L,t =2.93,P＜0.01]、FT3[ (3.61±0.49) pmol/L與(3.26±0.60)pmol/L,t=2.73,P＜0.01]、T4[(114.31±10:99) nmol/L與(110.28±16.91) nmol/L,t =4.58,P<0.01].結論 老年AECOPD患者T3、FT3、T4、FT4濃度降低；閤併呼吸衰竭患者下降更為明顯；積極治療可提高甲狀腺激素濃度,從而改善病情.甲狀腺激素濃度的變化對老年AECOPD患者病情判斷、療效分析、預後估計有一定臨床意義.
목적 분석노년만성조새성폐질병급성가중기(AECOPD)환자혹합병호흡쇠갈치료전후갑상선격소변화특점,탐토기림상의의.방법 선택노년AECOPD환자40례,측정기치료전、후급합병호흡쇠갈시갑상선격소농도；령선택여지년령필배적건강체검자40명,동기측정기갑상선격소농도작위대조비교.결과 노년AECOPD환자혈청삼전갑상선원안산(T3)、혈청유리삼전갑상선원안산(FT3)、혈청갑상선소(T4)、혈청유리갑상선소(FT4)현저저우대조조:T3[(1.23±0.25) nmol/L여(1.70±0.29) nmol/L,t=3.97,P＜0.01]、FT3[(3.27±0.59) pmol/L여(4.48±0.95) pmol/L,t =6.09,P＜0.01]、T4[( 109.30±17.73) nmol/L여(116.01±18.72) nmol/L,t =6.94,P ＜0.01]、FT4[ (15.11 ±2.37)pmol/L여( 17.62±0.35) pmol/L,t=7.23,P＜0.01]；노년AECOPD합병호흡쇠갈자T3,FT3,T4,FT4저우미합병자:T3[ (1.08±0.10) nmol/L여(1.35±0.26) nmol/L,t=4.02,P＜0.01]、FT3[(2.89±0.41)pmol/L여(3.59±0.53) pmol/L,t=4.58,P＜0.01]、T4[(96.54±14.34) nmol/L여(115.20±26.10)nmol/L,t =2.71,P＜0.01]、FT4[(14.05±2.05) pmol/L여(17.11±1.55) pmol/L,t =5.37,P＜0.01];노년AECOPD환자치료후T3、FT3、T4농도교치료전승고,T3[(1.43±0.29) nmol/L여(1.25±0.25)nmol/L,t =2.93,P＜0.01]、FT3[ (3.61±0.49) pmol/L여(3.26±0.60)pmol/L,t=2.73,P＜0.01]、T4[(114.31±10:99) nmol/L여(110.28±16.91) nmol/L,t =4.58,P<0.01].결론 노년AECOPD환자T3、FT3、T4、FT4농도강저；합병호흡쇠갈환자하강경위명현；적겁치료가제고갑상선격소농도,종이개선병정.갑상선격소농도적변화대노년AECOPD환자병정판단、료효분석、예후고계유일정림상의의.
Objective To analyze the thyroid hormone levels before and after treatment in the patients with chronic obstructive pulmonary disease in acute exacerbation stage (AECOPD) with respiratory failure.Methods In 40 cases of elderly AECOPD patients with respiratory failure,the thyroid hormone levels before and after the treatment were measured.At the same time,the thyroid hormone levels in another 40 agematched healthy volunteers were determined.Results In elderly AECOPD patients,serum T3,FT3,T4 and FT4were significantly lower than that of the control group:T3 ( [ 1.23 ± 0.25 ] nmol/L vs.[ 1.70 ± 0.29 ] nmol/L,t =3.97,P＜0.01),FT3( [3.27 ±0.59] pmol/L vs.[4.48 ±0.95] pmol/L,t =6.09,P ＜0.01),T4 ([ 109.3 ±17.73 ] nmol/L vs.[ 116.01 ± 18.72 ] nmol/L,t =6.94,P ＜0.01 ),FT4( [ 15.11 ±2.37] pmol/L vs.[ 17.62 ±0.35 ] pmol/L,t =7.23,P ＜ 0.01 ) ; While in the elderly AECOPD patients with respiratory failure,the T3,FT3,T4 and FT4 were lower than those patients without respiratory failure:T3 ( [ 1.08 ± 0.10 ] nmol/L vs.[ 1.35 ±0.26 ] nmol/L,t =4.02,P ＜ 0.01 ),FT3 ( [ 2.89 ± 0.41 ] pmol/L vs.[ 3.59 ± 0.53 ] pmol/L,t =4.58,P ＜0.01 ),T4 ([96.54 ± 14.34] nmol/L vs.[ 115.20 ± 26.10] nmol/L,t =2.71,P ＜ 0.01 ),FT4 ( [ 14.05 ±2.05 ] pmol/L vs.[ 17.11 ± 1.55 ] pmol/L,t =5.37,P ＜ 0.01 ).In elderly AECOPD patients,the post-treatment T3,FT3 and T4 levels were elevated compared with that before treatment.The difference was statistically significant:T3 ( [ 1.43 ± 0.29 ] nmol/L vs.[ 1.25 ± 0.25 ] nmol/L,t =2.93,P ＜ 0.01 ),FT3 ( [ 3.61 ± 0.49 ]pmol/L vs.[3.26 ± 0.60] pmol/L,t =2.73,P ＜ 0.01 ),T4 ( [ 114.31 ± 10.99] nmol/L vs.[ 110.28 ± 16.91 ]nmol/L,t =4.58.P ＜0.01).Conclusion In elderly AECOPD patients,the T3,FT3,T4 and FT4 levels are reduced and those in AECOPD patients with respiratory failure were decreased even more.Supportive treatment is able to enhance the thyroid hormone levels and improve the patients' condition.Therefore,the level of thyroid hormone in elderly AECOPD patients is useful to predict the patient's condition and prognosis.
