The significance of thyroid hormone levels in the elderly AECOPD patients

Abstract

Objective To analyze the thyroid hormone levels before and after treatment in the patients with chronic obstructive pulmonary disease in acute exacerbation stage (AECOPD) with respiratory failure.Methods In 40 cases of elderly AECOPD patients with respiratory failure,the thyroid hormone levels before and after the treatment were measured.At the same time,the thyroid hormone levels in another 40 agematched healthy volunteers were determined.Results In elderly AECOPD patients,serum T3,FT3,T4 and FT4were significantly lower than that of the control group:T3 ( [ 1.23 ± 0.25 ] nmol/L vs.[ 1.70 ± 0.29 ] nmol/L,t =3.97,P＜0.01),FT3( [3.27 ±0.59] pmol/L vs.[4.48 ±0.95] pmol/L,t =6.09,P ＜0.01),T4 ([ 109.3 ±17.73 ] nmol/L vs.[ 116.01 ± 18.72 ] nmol/L,t =6.94,P ＜0.01 ),FT4( [ 15.11 ±2.37] pmol/L vs.[ 17.62 ±0.35 ] pmol/L,t =7.23,P ＜ 0.01 ) ; While in the elderly AECOPD patients with respiratory failure,the T3,FT3,T4 and FT4 were lower than those patients without respiratory failure:T3 ( [ 1.08 ± 0.10 ] nmol/L vs.[ 1.35 ±0.26 ] nmol/L,t =4.02,P ＜ 0.01 ),FT3 ( [ 2.89 ± 0.41 ] pmol/L vs.[ 3.59 ± 0.53 ] pmol/L,t =4.58,P ＜0.01 ),T4 ([96.54 ± 14.34] nmol/L vs.[ 115.20 ± 26.10] nmol/L,t =2.71,P ＜ 0.01 ),FT4 ( [ 14.05 ±2.05 ] pmol/L vs.[ 17.11 ± 1.55 ] pmol/L,t =5.37,P ＜ 0.01 ).In elderly AECOPD patients,the post-treatment T3,FT3 and T4 levels were elevated compared with that before treatment.The difference was statistically significant:T3 ( [ 1.43 ± 0.29 ] nmol/L vs.[ 1.25 ± 0.25 ] nmol/L,t =2.93,P ＜ 0.01 ),FT3 ( [ 3.61 ± 0.49 ]pmol/L vs.[3.26 ± 0.60] pmol/L,t =2.73,P ＜ 0.01 ),T4 ( [ 114.31 ± 10.99] nmol/L vs.[ 110.28 ± 16.91 ]nmol/L,t =4.58.P ＜0.01).Conclusion In elderly AECOPD patients,the T3,FT3,T4 and FT4 levels are reduced and those in AECOPD patients with respiratory failure were decreased even more.Supportive treatment is able to enhance the thyroid hormone levels and improve the patients' condition.Therefore,the level of thyroid hormone in elderly AECOPD patients is useful to predict the patient's condition and prognosis. Key words: Chronic obstructive pulmonary disease; Acute exacerbations; Thyroid hormone