Guldiken Sibel, Tugrul Armagan, Altiay Gundeniz, Hacimahmutoglu Sevim, Durmuş-Altun Gülay
Department of Endocrinology and Metabolism, Trakya University School of Medicine, Turkey.
Ann Nucl Med. 2005 Sep;19(6):523-7. doi: 10.1007/BF02985583.
The mechanisms of dyspnea and exercise intolerance have not been fully elucidated. We aimed to investigate the clearance rate of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) from lungs in hyperthyroid patients without clinical evidence of lung disease and to explore the interactions between their Tc-99m DTPA radioaerosol lung scintigraphy, spirometric measurements, and the levels of thyroid hormones.
We studied 19 hyperthyroid patients and 16 sex- and age-matched controls. Thyroid hormone levels were assessed. Spirometric lung function tests, diffusing capacity of the lung for carbon monoxide (DLCO) and the clearance rate of Tc-99m DTPA were performed in all participants. Ratio of DLCO value to the alveolar ventilation (DLCO/VA) and the means of half-time (T1/2) of Tc-99m DTPA clearance rate, which were used to evaluate alveolar-capillary membrane permeability, were calculated.
There were no statistical differences between spirometric parameters (VC, FVC, FEV1/FVC, FEF 25-75) of the two groups (p > 0.05). Although the mean FEV1 level was significantly lower in the hyperthyroid patients than the control subjects (p < 0.01), in five patients FEV1 was only less than 80 percent of the predicted value. No significant difference in the means of DLCO, DLCO/VA or T1/2 values of Tc-99m DTPA clearance was observed between the two groups (p > 0.05). In hyperthyroid patients, there was a positive relation between DLCO/VA, DLCO/VA % and T1/2 values of Tc-99m DTPA clearance (p < 0.01, r = 0.732, p < 0.01, r = 0.742, respectively). The lung volumes and the levels of thyroid hormones did not show a significant relationship to T1/2 values of Tc-99m DTPA clearance in hyperthyroid group (p > 0.05).
We conclude that increased thyroid hormones have no effect on permeability of alveolar-capillary membrane in hyperthyroid patients.
呼吸困难和运动不耐受的机制尚未完全阐明。我们旨在研究无肺部疾病临床证据的甲状腺功能亢进患者肺内99m锝-二乙三胺五乙酸（Tc-99m DTPA）的清除率，并探讨其Tc-99m DTPA放射性气溶胶肺闪烁扫描、肺量计测量结果与甲状腺激素水平之间的相互关系。
我们研究了19例甲状腺功能亢进患者和16例性别及年龄匹配的对照者。评估甲状腺激素水平。对所有参与者进行肺量计肺功能测试、肺一氧化碳弥散量（DLCO）及Tc-99m DTPA清除率测定。计算用于评估肺泡-毛细血管膜通透性的DLCO值与肺泡通气量之比（DLCO/VA）以及Tc-99m DTPA清除率的半衰期（T1/2）均值。
两组的肺量计参数（肺活量、用力肺活量、第一秒用力呼气容积/用力肺活量、25%-75%用力呼气流量）无统计学差异（p>0.05）。虽然甲状腺功能亢进患者的平均第一秒用力呼气容积水平显著低于对照组（p<0.01），但有5例患者的第一秒用力呼气容积仅低于预测值的80%。两组之间在DLCO、DLCO/VA或Tc-99m DTPA清除率的T1/2值均值方面未观察到显著差异（p>0.05）。在甲状腺功能亢进患者中，DLCO/VA、DLCO/VA%与Tc-99m DTPA清除率的T1/2值之间存在正相关关系（分别为p<0.01，r=0.732；p<0.01，r=0.742）。甲状腺功能亢进组的肺容积和甲状腺激素水平与Tc-99m DTPA清除率的T1/2值之间未显示出显著关系（p>0.05）。
我们得出结论，甲状腺激素升高对甲状腺功能亢进患者的肺泡-毛细血管膜通透性无影响。
