CAJ | 학술논문

目的：探讨甲状腺激素（ TSH）、促甲状腺激素、皮质醇及血糖在重度慢性阻塞性肺疾病急性加重期（ AECOPD）并需要机械通气患者中的变化及临床意义。方法采用时间分辨全自动免疫分析仪测定2012－12～2014－12我院ICU 51例重度AECOPD病例各项激素指标变化情况，取同期健康人群40例作对照组。结果重度AECOPD机械通气患者甲状腺激素及TSH明显低于正常对照组（P＜0．05），而皮质醇及血糖明显高于正常对照组（P＜0．05）。27例撤机成功者甲状腺激素与TSH明显高于12例撤机失败者（ P＜0．05）。结论重度AECOPD机械通气患者可以出现下丘脑－垂体－肾上腺（ HPA）轴、下丘脑－垂体－甲状腺轴受损，测定血清甲状腺激素、TSH、皮质醇及血糖可预估机械通气患者撤机成败，在临床中对把握撤机时机及判断预后有重要指导意义。
목적：탐토갑상선격소（ TSH）、촉갑상선격소、피질순급혈당재중도만성조새성폐질병급성가중기（ AECOPD）병수요궤계통기환자중적변화급림상의의。방법채용시간분변전자동면역분석의측정2012－12～2014－12아원ICU 51례중도AECOPD병례각항격소지표변화정황，취동기건강인군40례작대조조。결과중도AECOPD궤계통기환자갑상선격소급TSH명현저우정상대조조（P＜0．05），이피질순급혈당명현고우정상대조조（P＜0．05）。27례철궤성공자갑상선격소여TSH명현고우12례철궤실패자（ P＜0．05）。결론중도AECOPD궤계통기환자가이출현하구뇌－수체－신상선（ HPA）축、하구뇌－수체－갑상선축수손，측정혈청갑상선격소、TSH、피질순급혈당가예고궤계통기환자철궤성패，재림상중대파악철궤시궤급판단예후유중요지도의의。
Objective To explore the clinical value of thyroid hormone , thyroid-stimulating hormone ( TSH) , cortisol and blood sugar in severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with mechanical ventilation .Methods The levels of hormones came from 51 AECOPD patients that were in ICU from 2012 .12 to 2014 .12 were measured by Wallace Autodelfia Immunassay System .Hormone levels taken from 40 cases of healthy people served as control .Results The data showed that the levels of thyroid hormone , TSH in AECOPD patients were significantly lower than those of control group (P<0.05), but the levels of cortisol and blood sugar in AECOPD patients were significantly higher than those of control group (P <0.05).Thyroid hormone and TSH in 27 patients who were successfully weaned were significantly higher than those in 12 patients who were not successfully weaned (P<0.05).Conclusion Severe AECOPD patients with mechanical ventilation can appear the damage of the hypothalamic -pituitary -adrenal ( HPA ) axis and hypothalamic -pituitary-thyroid axis.The levels of thyroid hormone , TSH, cortisol and blood glucose may be used for the estimation on prognosis of patients weaning from mechanical ventilation .