血清甲状腺激素在老年慢性阻塞性肺疾病合并呼吸衰竭患者中的临床研究

目的研究不同发病阶段老年慢性阻塞性肺部疾病(慢阻肺)合并呼吸衰竭重症病人中血清TH水平的变化情况以及预后影响的研究。方法筛选48人老年慢阻肺伴随呼吸衰竭症重症病人为观察组研究对象,对照组48人为相同年龄段的单纯慢阻肺患者。应用时间荧光分辨免疫技术定时检测所有参与者的血清中三碘甲状腺原氨酸(TT_3)、血清甲状腺素(TT_4)、游离TT_3(FT_3)、游离TT_4(FT4)及促甲状腺激素(TSH)的水平,判断其变化情况。结果老年慢阻肺伴随呼吸衰竭症重症病人者TT_3比对照组要低很多(P0.05),有显著性的差别。观察组TT_4、FT_4、TSH和对照组差距不大(P0.05),没有显著性的差别。观察组中病死组病人TT_3、TT_4、FT_3、FT_4都比存活组低很多(P0.05),有显著性差异;TSH水平差异没有显著性(P0.05)。结论血清TH水平变化情况能够反映出老年慢阻肺伴随呼吸衰竭症重症病人的发病情况,老年慢阻肺伴随呼吸衰竭症重症病人TT_3明显低,检测的血清TT_3作为指标能有效诊断老年慢阻肺伴随呼吸衰竭重症病人发病情况及其预后估计。

Clinical research of serum thyroid hormone in elderly COPD patients complicated with respiratory failure

Objective To study the changes of serum thyroid hormone in elderly COPD patients complicated with respiratory failure and its value on prognosis. Methods 48 senile COPD patients complicated with respiratory failure at acute aggravating period were chosen as the observation group,and another 48 patients only with COPD were taken as the control groups. It used time fluorescence immunity analysis technical to test serum thyroid original glycine(TT3 ),three free iodine thyroid former glycine(FT3 ),serum thyroxine(TT4 ),free thyroxine(FT4 )and serum thyroid stimulating hormone(TSH). Results The level of TT3 was obviously lower in the observation group than in the control group(P < 0. 05),but the level of TT4 ,FT4 and TSH showed no significant difference between the two groups(P > 0. 05). In the observation group,the levels of TT3 ,TT4 ,FT3 and FT4 was lower in the death group than in the survival group(P < 0. 05),but the level of TSH showed no significant difference(P > 0. 05). Conclusion Serum TH level change reflects the senile COPD patients with the incidence of severe respiratory failure symptoms and respiratory failure. Compared with patients only with COPD,TT3 is significantly lower,and the detec-tion of serum TT3 can effectively help to make a diagnosis and prognosis.