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慢性阻塞性肺疾病与甲状腺功能紊乱。

COPD and thyroid dysfunctions.

机构信息

Respiratory Diseases Unit, School of Specialization in Respiratory Diseases, University of Rome "La Sapienza", Policlinico Umberto I, Viale del Policlinico no 155, 00161, Rome, Italy,

出版信息

Lung. 2014 Feb;192(1):103-9. doi: 10.1007/s00408-013-9537-6. Epub 2013 Nov 27.

Abstract

BACKGROUND

Chronic obstructive pulmonary (COPD) is one of the major causes of morbidity and mortality in the world. COPD is characterized by chronic inflammation in the pulmonary compartment and in the systemic circulation. This disorder is associated with clinically significant alterations in biochemistry and organ function; thyroid dysfunctions are common in chronic diseases, such as COPD. Several characteristics of COPD patients could increase their likelihood of developing hypothyroidism or hyperthyroidism. The purpose of our study was to assess the impact of thyroid dysfunction in patients with COPD.

METHODS

We evaluated the pulmonary function tests, arterial blood gases, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and thyroid functions in patients with COPD, recruited between admissions in Respiratory Diseases Unit, Policlinico Umberto I, Rome, Italy, from June 2012 to May 2013. We selected patients with subclinical hypothyroidism (ScH), overt hypothyroidism, and hyperthyroidism, and a control group without thyroid disturbance.

RESULTS

Our results indicate that patients with overt hypothyroidism have lower levels of pO2, MIP, and MEP compared with subjects with ScH, hyperthyroidism, and the control group. We also found a substantial tendency towards pCO2 levels increase in patients with hypothyroidism (p = 0.06).

CONCLUSIONS

Patients with thyroid dysfunctions have a greater impairment of MIP and MEP and a negative correlation was observed between hypoxemia and TSH. Further studies are needed to investigate whether the treatment of thyroid disfunction could have a beneficial effect on COPD patients' lung function and prognosis.

摘要

背景

慢性阻塞性肺疾病(COPD)是世界上发病率和死亡率的主要原因之一。COPD 的特征是肺部和全身循环中的慢性炎症。这种疾病与生物化学和器官功能的临床显著改变有关;甲状腺功能障碍在慢性疾病中很常见,如 COPD。COPD 患者的一些特征可能会增加他们发生甲状腺功能减退或甲状腺功能亢进的可能性。我们研究的目的是评估甲状腺功能障碍对 COPD 患者的影响。

方法

我们评估了 2012 年 6 月至 2013 年 5 月期间在意大利罗马乌姆伯托一世综合医院呼吸疾病科住院的 COPD 患者的肺功能检查、动脉血气、最大吸气压力(MIP)、最大呼气压力(MEP)和甲状腺功能。我们选择了亚临床甲状腺功能减退症(ScH)、显性甲状腺功能减退症和甲状腺功能亢进症的患者,并选择了没有甲状腺功能障碍的对照组。

结果

我们的结果表明,与 ScH、甲状腺功能亢进症和对照组相比,显性甲状腺功能减退症患者的 pO2、MIP 和 MEP 水平较低。我们还发现甲状腺功能减退症患者的 pCO2 水平有明显升高的趋势(p=0.06)。

结论

甲状腺功能障碍患者的 MIP 和 MEP 损伤更大,并且低氧血症与 TSH 之间存在负相关。需要进一步研究以探讨治疗甲状腺功能障碍是否对 COPD 患者的肺功能和预后有有益影响。

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