老年COPD肺心病患者血清甲状腺激素的观察分析

目的探讨老年COPD肺心病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合并肺心病急性发作组42例，缓解组30例，对照组35例，血清TT3、FT3、TT4、FT4和TSH水平，同步抽取外周动脉血作血气分析，并对数据进行统计学分析。结果COPD合并肺心病急性发作各组血清TT3，FT3，IT4，FT4均值均明显低于对照组（P〈0．05或P〈0．01），亦低于缓解期患者（P〈0．05），差异有显著性。血清TSH在各组之间差异无统计学意义。经治疗，心功能改善后，血清TT3，FT3，TT4，FT4显著回升，TSH无显著性变化（P〉0．05）。结论老年COPD合并肺心病患者，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 on thyroid hormone in aged patients with COPD and chronic pulmonary heart disease

Objective To investigate the change of thyroid hormone in chronic cor pulmonal cm patients with COPD. Methods The levels of TT3 ,FT3 ,TT4 , FT4 and TSH were tested in 72 patients with chronic cot pulmonal patients and COPD （ including stable period and exacerbation period） and 35 healthy controls by radiommunossay. 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 tile stable period and higher in patients than in the healthy controls （ P 〈0. 01 ）. The serum TSH level showed no significant difference between the groups （ P 〉 0. 05 ）. Conclusion The serum thyroid hormone levels is valuable in the prediction of the disease progress and progress for cot pulmonale patients.