甲状腺功能与慢性阻塞性肺疾病急性加重的关系。
Association Between Thyroid Function and Acute Exacerbation of Chronic Obstructive Pulmonary Disease.
机构信息
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2021 Feb 17;16:333-339. doi: 10.2147/COPD.S291807. eCollection 2021.
PURPOSE
Chronic obstructive pulmonary disease (COPD) was the fourth leading cause of death in the world. Many studies have shown that COPD often exists with thyroid dysfunction; however, the relationship between thyroid function and COPD is often ignored in clinical. We retrospectively analyze the serum thyroid hormone levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and explore the association between thyroid function and AECOPD.
METHODS
The study included patients hospitalized for AECOPD in our institution between January 2018 and September 2020. Patients with AECOPD were divided into moderate-to-severe and very severe groups based on lung function, and into normal and abnormal thyroid function groups based on thyroid hormone levels. Collected data and compared data between groups to identify risk factors for thyroid dysfunction in patients with AECOPD.
RESULTS
The cohort included 97 in the moderate-to-severe group (72.39%) and 37 in the very severe group (27.61%). Compared with the very severe group, the moderate-to-severe group had higher triglyceride (=0.017), high-density lipoprotein (<0.05), partial pressure of carbon dioxide (PaCO; <0.05), and serum thyroid-stimulating hormone (TSH; <0.001). FEV as a percentage of the predicted value (FEV%pred) was positively correlated with TSH and FT (=0.329, =0.192, respectively, both <0.05). Duration of hospitalization was negatively correlated with TSH (=-0.256, =0.003). Among the 134 subjects, 98 (73.13%) had normal thyroid function and 36 (26.87%) had abnormal thyroid function. The two groups significantly differed regarding forced vital capacity (FVC), forced expiratory volume in 1 second, FEV%pred, and albumin level. Logistic regression analysis showed that high FVC correlated with a low risk of thyroid dysfunction in AECOPD.
CONCLUSION
In patients with AECOPD, TSH is related to lung function and duration of hospitalization, and high FVC reduces the risk of thyroid dysfunction.
目的
慢性阻塞性肺疾病（COPD）是世界上第四大致死原因。许多研究表明，COPD 常与甲状腺功能障碍并存；然而，甲状腺功能与 COPD 之间的关系在临床中往往被忽视。我们回顾性分析了我院收治的慢性阻塞性肺疾病急性加重（AECOPD）患者的血清甲状腺激素水平，探讨了甲状腺功能与 AECOPD 的关系。
方法
本研究纳入了 2018 年 1 月至 2020 年 9 月在我院住院治疗的 AECOPD 患者。根据肺功能将患者分为中重度和重度两组，并根据甲状腺激素水平将患者分为甲状腺功能正常和异常两组。收集数据并比较组间数据，以确定 AECOPD 患者甲状腺功能障碍的危险因素。
结果
该队列包括中重度组 97 例（72.39%）和重度组 37 例（27.61%）。与重度组相比，中重度组的甘油三酯（=0.017）、高密度脂蛋白（<0.05）、二氧化碳分压（PaCO；<0.05）和血清促甲状腺激素（TSH；<0.001）更高。FEV 占预计值的百分比（FEV%pred）与 TSH 和 FT 呈正相关（=0.329，=0.192，均<0.05）。住院时间与 TSH 呈负相关（=-0.256，=0.003）。在 134 例患者中，98 例（73.13%）甲状腺功能正常，36 例（26.87%）甲状腺功能异常。两组在用力肺活量（FVC）、第 1 秒用力呼气量、FEV%pred 和白蛋白水平方面有显著差异。Logistic 回归分析表明，FVC 高与 AECOPD 患者甲状腺功能障碍的风险低相关。
结论
在 AECOPD 患者中，TSH 与肺功能和住院时间有关，FVC 高可降低甲状腺功能障碍的风险。
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