血清甲状腺激素在老年慢性阻塞性肺疾病加重期的临床意义
摘要
目的探讨血清甲状腺激素水平对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者病情的评估价值。方法年龄≥60岁的133例AECOPD患者,根据是否符合低总三碘甲状腺原氨酸(T3)综合征的诊断分为低T3综合征(低T3)组(n=67)和非低T3综合征(非低T3)组(n=66),并进行临床资料分析。结果与非低T3组相比,低T3组合并冠心病、慢性心力衰竭、糖尿病者更多,白细胞计数、C反应蛋白明显升高,血清白蛋白及动脉血氧分压明显降低,住院期间病死率更高(均P<0.05)。结论合并低T3综合征的AECOPD患者预后差,监测患者甲状腺激素水平有助于对病情及预后做出评估。
引文
1 中华医学会呼吸病学分会慢性阻塞性肺病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013;36(4):255-64.
2 文富强.重视慢性阻塞性肺疾病的合并症[J].中华肺部疾病杂志(电子版),2013;6(2):1-3.
3 Tsai CL,Sobrino JA,Camargo CA.National study of emergency department visits for acute exacerbation of chronic obstructive pulmonary disease,1993-2005[J].Acad Emerg Med,2014;15(12):1275-83.
4 刘艳清,张珍,邵加庆.低T3综合征研究进展[J].医学研究生学报,2014;27(9):978-81.
5 Wang C,Xu J,Yang L,et al.Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study):a national cross-sectional study[J].Lancet,2018;391(10131):1706-17.
6 Karadag F,Ozcan H,Karul AB,et al.Correlates of non-thyroidal illness syndrome in chronic obstructive pulmonary disease[J].Res Med,2007;101(7):1439-46.
7 董燕,乔莉,龚晨,等.年龄与老年人低T3综合征的相关性[J].中国老年学杂志,2016;36(20):5011-3.
8 董燕,严祥,申潇竹,等.低T3综合征与血清白蛋白的相关性[J].中国老年学杂志,2016;36(1):163-5.
9 程洋,戴丽,夏国光.慢性阻塞性肺疾病急性加重患者血清甲状腺激素水平变化及临床意义[J].中华结核和呼吸杂志,2016;39(12):939-43.
10 Mancini A,Corbo GM,Gaballo A,et al.Relationship between plasma antioxidants and thyroid hormones in chronic obstructive pulmonary disease[J].Exp Clin Endoc Diab,2012;120(10):623-8.
11 Vidart J,Magagnin WS,Sarmento LR,et al.N-acetylcysteine administration prevents nonthyroidal illness syndrome in patients with acute myocardial infarction:a randomized clinical trial[J].J Clin Endocrinol Metab,2014;99(12):4537-45.
12 Warner MH,Beckett GJ.Mechanisms behind the non-thyroidal illness syndrome:an update[J].J Endocrinol,2010;205(1):1-13.
13 Iervasi G,Pingitore A,Landi P,et al.Low-T3 syndrome:a strong prognostic predictor of death in patients with heart disease[J].Circulation,2003;107(5):708-13.
14 陈绍稀,吕晶,虞意华,等.甲状腺激素对心力衰竭伴低T3综合征患者心功能影响的Meta分析[J].心脑血管病防治,2014;14(1):22-6.
15 张海燕,董磊,吴彩军,等.低T3综合征在急诊重症患者发病率及T3对预后的评估[J].中华急诊医学杂志,2013;22(10):1132-5.
2 文富强.重视慢性阻塞性肺疾病的合并症[J].中华肺部疾病杂志(电子版),2013;6(2):1-3.
3 Tsai CL,Sobrino JA,Camargo CA.National study of emergency department visits for acute exacerbation of chronic obstructive pulmonary disease,1993-2005[J].Acad Emerg Med,2014;15(12):1275-83.
4 刘艳清,张珍,邵加庆.低T3综合征研究进展[J].医学研究生学报,2014;27(9):978-81.
5 Wang C,Xu J,Yang L,et al.Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study):a national cross-sectional study[J].Lancet,2018;391(10131):1706-17.
6 Karadag F,Ozcan H,Karul AB,et al.Correlates of non-thyroidal illness syndrome in chronic obstructive pulmonary disease[J].Res Med,2007;101(7):1439-46.
7 董燕,乔莉,龚晨,等.年龄与老年人低T3综合征的相关性[J].中国老年学杂志,2016;36(20):5011-3.
8 董燕,严祥,申潇竹,等.低T3综合征与血清白蛋白的相关性[J].中国老年学杂志,2016;36(1):163-5.
9 程洋,戴丽,夏国光.慢性阻塞性肺疾病急性加重患者血清甲状腺激素水平变化及临床意义[J].中华结核和呼吸杂志,2016;39(12):939-43.
10 Mancini A,Corbo GM,Gaballo A,et al.Relationship between plasma antioxidants and thyroid hormones in chronic obstructive pulmonary disease[J].Exp Clin Endoc Diab,2012;120(10):623-8.
11 Vidart J,Magagnin WS,Sarmento LR,et al.N-acetylcysteine administration prevents nonthyroidal illness syndrome in patients with acute myocardial infarction:a randomized clinical trial[J].J Clin Endocrinol Metab,2014;99(12):4537-45.
12 Warner MH,Beckett GJ.Mechanisms behind the non-thyroidal illness syndrome:an update[J].J Endocrinol,2010;205(1):1-13.
13 Iervasi G,Pingitore A,Landi P,et al.Low-T3 syndrome:a strong prognostic predictor of death in patients with heart disease[J].Circulation,2003;107(5):708-13.
14 陈绍稀,吕晶,虞意华,等.甲状腺激素对心力衰竭伴低T3综合征患者心功能影响的Meta分析[J].心脑血管病防治,2014;14(1):22-6.
15 张海燕,董磊,吴彩军,等.低T3综合征在急诊重症患者发病率及T3对预后的评估[J].中华急诊医学杂志,2013;22(10):1132-5.