老年COPD合并呼吸衰竭患者血清甲状腺激素变化观察分析

目的探讨老年COPD合并呼吸衰竭患者血清甲状腺激素水平的变化。方法用放射免疫法分别测定COPD缓解期患者50例，COPD急性加重期无呼衰患者42例，COPD急性加重期合并呼衰患者53例血清TT3、FT3、TT4、FT4和TSH水平并对数据进行统计学分析。结果急性加重期各组血清TT3，FT3，TT4，FT4均值均明显低于缓解期患者（P〈0．05），差异有显著性，其中以呼衰组患者最低。FT3，TT3水平下降与Pa02下降成正相关。死亡组TT3，FT3，TT4，FT4水平低于存活组（P〈0．05），但TSH值无明显差异。结论老年COPD合并呼吸衰竭患者，存在低甲状腺激素综合症，血清甲状腺激素水平有助于判断病情的严重程度，亦有助于疗效观察及估计预后。

Observation of thyroxin level in aged patients with COPD and respiratory failure

Objective To investigate the change of thyroid hormone in aged patients with COPD and respiratory failure. Methods The levels of TT3 ,FT3 ,TT4 , FT4 and TSH were tested in 145 patients with COPD （include stable period and exacerbation period） , and the data were analyzed statistically by SPSS. Results The serum TT3, FT3,TT4 and FT4 levels in patients with cor pulmonal were significantly lower during the exacerbation period than the stable period （P 〈 0. 01 ）. The serum TSH level showed no significant difference between the groups （ P 〉 0. 05 ）. Conclusion The serum thyroid hormone levels of aged patients with COPD in acute exacerbation period are abnormal and related with the severity, progress and prognosis of COPD.