短期低剂量甲状腺激素替代疗法对COPD合并非甲状腺疾病综合征患者的疗效

发布时间：2018-03-10 03:01

本文选题：慢性阻塞性肺疾病　切入点：非甲状腺疾病综合征　出处：《山东医药》2017年29期 　论文类型：期刊论文

【摘要】：目的探讨短期低剂量甲状腺激素替代疗法对慢性阻塞性肺疾病(COPD)合并非甲状腺疾病综合征患者的疗效。方法选取COPD合并非甲状腺疾病综合征患者146例,随机分为对照组、短期治疗组和长期治疗组,对照组只进行对症治疗,短期和长期治疗组在对症治疗的基础上、TSH分别进行为期1周和1个月的低剂量甲状腺激素替代治疗,并于治疗前、治疗结束后对患者的肺功能[第1秒用力呼气容积(FEV_1)和第1秒用力呼气容积占用力肺活量百分比(FEV_1/FVC)]、甲状腺激素水平(包括总T3、总T4、游离T3、游离T4、TSH)、细胞因子水平(包括TNF-α、IL-6、IL-10、TGF-β)以及淋巴细胞亚群(包括CD3~+T、CD4~+T、CD8~+T和CD4~+CD25~+T细胞)进行测定。结果与治疗前比较,治疗后对照组FEV_1%pred及FEV_1/FVC升高,短期及长期治疗组FEV_1%pred、FEV_1/FVC、FT3、TT3、TT4、IL-10升高,FT4、IL-6、TGF-α、TGF-β降低(P均0.05)。与对照组比较,短期治疗组FEV_1%pred、FEV_1/FVC、FT3、FT4、TT3、TT4升高;长期治疗组FEV_1%pred、FEV_1/FVC、FT3、FT4、TT3、TT4升高,TSH、TGF-β降低(P均0.05);两治疗组CD4~+、CD25~+T细胞百分比升高、CD4~+T细胞百分比降低(P均0.05)。两治疗组间除TSH水平差异有统计学意义外,其他指标比较,P均0.05。结论短期低剂量甲状腺激素替代疗法治疗COPD可以改善患者呼吸功能,降低血清炎性因子以及改善外周血T淋巴细胞亚群的分布,与长期低剂量甲状腺激素替代治疗效果相当,但不良作用少。
[Abstract]:Objective to investigate the efficacy of short-term low-dose thyroid hormone replacement therapy in patients with chronic obstructive pulmonary disease (COPD) and non-thyroid disease syndrome. Methods 146 patients with COPD and non-thyroid disease syndrome were randomly divided into control group. In the short-term treatment group and the long-term treatment group, the control group was treated only with symptomatic therapy, and the short-term and long-term treatment groups were treated with low-dose thyroid hormone replacement therapy for one week and one month, respectively, on the basis of the symptomatic treatment, and before the treatment, At the end of the treatment, the lung function [forced expiratory volume (FEV _ 1) and forced expiratory volume occupied vital capacity percentage (FEV _ 1 / FVC)], thyroid hormone level (including total T _ 3, total T _ 4, free T _ 3, free T _ 4 T _ 4, free T _ 4 T _ 4 TSHN, cytokine levels) were measured after treatment. Including TNF- 伪, IL-6, IL-10, TGF- 尾) and lymphocyte subsets (including CD3 ~ TnCD4 ~ TnCD8 ~ T and CD4 ~ CD25 ~ T cells), the results were compared with those before treatment. After treatment, FEV_1%pred and FEV_1/FVC increased in the control group, and FEV in the short and long term treatment group, FEV1 / FEVCX / FT3 / TT4T4 / IL-10 increased. Compared with the control group, FEV1 prefered FEV1 / FEV1 / FVC1 / FT3 / FT3TT4 / TT4 was increased in the short-term treatment group compared with that in the control group (P < 0. 05), and compared with the control group, FEV1 prefered FEV1 / FVC1 / FVC1 / FT3 / FT3TT4 was increased in the short term treatment group (P < 0. 05). In the long-term treatment group, FEV1pred / FEV1 / FVCU / FT4TGF- 尾 increased and CD4 ~ + CD25 ~ T cell percentage increased and CD4 ~ T cell percentage decreased (P = 0.05). There was significant difference between the two treatment groups except for the TSH level, and there was no significant difference between the two groups in the level of TGF- 尾 and TGF- 尾 in the treatment group, and in the treatment group, the percentage of CD4 ~ T cells increased and the percentage of CD4 ~ T cells decreased in the two treatment groups (P < 0.05), but there was a significant difference between the two groups. Conclusion Short-term low-dose thyroid hormone replacement therapy can improve respiratory function, decrease serum inflammatory factors and improve the distribution of T lymphocyte subsets in patients with COPD. Compared with long-term low-dose thyroid hormone replacement therapy, but the adverse effect is less.
【作者单位】：中国医科大学附属第四医院;
【分类号】：R563.9

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