摘要
目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者血清白细胞介素6(IL-6)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平与甲状腺功能的相关性。方法回顾性研究。分析2017年5月至2020年5月昆明医科大学第二附属医院呼吸内科三病区住院治疗的AECOPD患者的临床资料。其中甲状腺功能正常组114例,异常组43例,比较2组间的甲状腺功能状态及其他临床指标;采用Spearman相关性分析AECOPD患者血清IL-6、PCT、hs-CRP水平与甲状腺功能的相关性;应用多因素Logstic回归分析筛选引起AECOPD患者甲状腺功能异常的危险因素。结果AECOPD合并甲状腺功能异常者27.4%(43/157),非甲状腺疾病综合征占16.6%(26/157)。2组间的糖皮质激素应用史差异有统计学意义(P<0.05);与甲状腺功能正常组比较,甲状腺功能异常组的白细胞、IL-6、PCT、hs-CRP、D-二聚体、N末端B型利钠肽前体均显著升高(P值均<0.05);而前白蛋白、白蛋白(ALB)、动脉血氧分压、用力肺活量、第1秒用力呼气容积、最大呼气流量均显著降低(P值均<0.05)。相关性分析结果显示,AECOPD患者中血清IL-6、PCT、hs-CRP分别与三碘甲状腺原氨酸(TT_(3))、游离三碘甲状腺原氨酸(FT_(3))呈负相关(P值均<0.05)。IL-6(OR=1.017,95%CI:1.001~1.034,P=0.038)、ALB(OR=0.899,95%CI:0.816~0.989,P=0.029)、PaO2(OR=0.959,95%CI:0.928~0.990,P=0.011)是引起AECOPD患者甲状腺功能异常的相关因素。结论糖皮质激素的应用可影响AECOPD患者的甲状腺功能。将甲状腺功能维持在正常水平有助于改善AECOPD患者的肺功能,并减轻其严重程度。AECOPD患者血清IL-6、PCT、hs-CRP与甲状腺功能呈负相关,TT_(3)、FT_(3)水平可随炎症反应加重而降低。IL-6、ALB、PaO2是引起AECOPD患者甲状腺功能异常的影响因素。
Objective To analyze the correlation between serum interleukin-6(IL-6),procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP)levels and thyroid function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods This was a retrospective study.The clinical data of AECOPD patients who were hospitalized in the Second Affiliated Hospital of Kunming Medical University from May 2017 to May 2020.Among them,there were 114 cases of AECOPD with normal thyroid function and 43 cases of AECOPD with abnormal thyroid function.The thyroid function status and other clinical indicators between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between serum IL-6,PCT,hs-CRP and thyroid function in patients with AECOPD.Multifactor logstic stepwise regression analysis was used to screen relevant factors for thyroid dysfunction in AECOPD patients.Results 27.4%(43/157)of AECOPD patients were associated with thyroid dysfunction,of which 16.6%(26/157)correlated with nonthyroid illness syndrome.The difference in glucocorticoid application history between the two groups was statistically significant(P<0.05).White blood cells(WBC),IL-6,PCT,hs-CRP,D-dimer(D-D),N-terminal pro-brain natriuretic peptide(NT-proBNP),pulmonary artery pressure were significantly increased in the abnormal group compared with the normal group(all P<0.05).But,prealbumin(PAB),albumin(ALB),arterial partial oxygen pressure(PaO2),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)were significantly decreased in the abnormal group(all P<0.05).Correlation analysis showed that the levels of blood serum IL-6,PCT,hs-CRP were negatively correlated with triiodothyronine(TT_(3)),free triiodothyronine(FT_(3))in patients with AECOPD(all P<0.05).IL-6(OR=1.017,95%CI:1.001-1.034,P=0.038),ALB(OR=0.899,95%CI:0.816-0.989,P=0.029)and PaO2(OR=0.959,95%CI:0.928-0.990,P=0.011)were relevant factors for thyroid dysfunction in AECOPD patients.Conclusions The use of glucocorticoids may affect thyroid function in patients with AECOPD.Maintaining thyroid function at normal levels can improve lung function of AECOPD patients and reduce the severity.There were negative correlation between serum IL-6,PCT,hs-CRP and thyroid function in patients with AECOPD,and TT_(3),FT_(3) levels can be reduced with the aggravation of inflammatory response.IL-6,ALB and PaO2 are relevant factors for thyroid dysfunction in patients with AECOPD.
作者
曹丽娇
袁开芬
Cao Lijiao;Yuan Kaifen(Third Department of Respiratory Medicine,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)
出处
《国际呼吸杂志》
2021年第19期1468-1475,共8页
International Journal of Respiration
基金
昆明医科大学硕士研究生创新基金(2020S185)。
关键词
肺疾病
慢性阻塞性
白细胞介素6
降钙素原
超敏C-反应蛋白
甲状腺功能
Pulmonary disease,chronic obstructive
Interleukin-6
Procalcitonin
Hypersensitive C-reactive protein
Thyroid function
