Jerez F R, Plaza V, Tárrega J, Casan P, Rodríguez J
Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau, Bercelona.
Arch Bronconeumol. 1998 Oct;34(9):429-32. doi: 10.1016/s0300-2896(15)30369-0.
Hyperthyroidism can cause asthma to worsen, such that analysis of thyroid function has been recommended when the course of asthma is unfavorable. The aim of this study was to determine whether systematic analysis of thyroid function is useful for all patients with difficult-to-manage asthma. For prospective study, we enrolled 48 asthmatics whose condition had deteriorated due to no known cause. All patients were studied as follows: a) all were assessed for thyrotropin (TSH) levels and, if alterations were detected, we ordered analysis of free thyroxin (FT4), and b) case histories were taken to rule out the existence of active thyroid disease. Nine patients (19%) were suspected of thyroid disease. TSH levels were abnormal in only 5 (10%) patients in this group (low in four and high in one). Hyperthyroidism was confirmed in only 3 patients (6%) after high FT4 levels were detected. Although the frequency of hyperthyroidism in the sample studied is higher than that described for the general population, the systematic investigation of thyroid dysfunction in all patients with difficult-to-manage asthma does not appear justified given that disease could be demonstrated in only some of those who were clinically suspected of thyroid disease.
甲状腺功能亢进会导致哮喘恶化，因此当哮喘病情不利时，建议对甲状腺功能进行分析。本研究的目的是确定对所有难治性哮喘患者进行甲状腺功能系统分析是否有用。在这项前瞻性研究中，我们招募了48名病情因不明原因而恶化的哮喘患者。所有患者均按以下方式进行研究：a）对所有患者进行促甲状腺激素（TSH）水平评估，若检测到异常，则进一步检测游离甲状腺素（FT4）；b）采集病史以排除活动性甲状腺疾病的存在。9名患者（19%）被怀疑患有甲状腺疾病。该组中仅有5名患者（10%）的TSH水平异常（4名降低，1名升高）。在检测到FT4水平升高后，仅3名患者（6%）被确诊为甲状腺功能亢进。尽管在所研究的样本中甲状腺功能亢进的发生率高于一般人群，但鉴于仅在部分临床怀疑患有甲状腺疾病的患者中证实了该疾病，因此对所有难治性哮喘患者进行甲状腺功能障碍的系统调查似乎并无必要。
