CHANGES IN THYROID FUNCTION IN PATIENTS WITH ACUTE EXACERBATION OF Cl IRONIC OBSTRUCTIVE PULMONARY DISEASE AND ITS CLINICAL SIGNIFICANCE

Objective: To investigate the changes of thyroid function in patients with the acute exacerbation of chronic obstructive pulmonary disease (COPD) and its clinical significance. Methods: In total, 239 patients with acute exacerbation of COPD (AECOPD) admitted to the Department of Respiratory Medicine, Jishuitan Hospital of Beijing from 2014 to 2017 were selected as the observation group, including 51 dead patients and 188 discharged patients who had improved. Fifty-six healthy people who received physical examination in the same period were selected as the control group. The levels of serum total triiodothyronine (TT3) total thyroxine (TT4), free triiodothymnine (FT3), free thyroxine (FT4) and serum thyroid stimulating hormone (TSH) of 8AM, 4PM and 12MN were compared between the two groups after admission, and the oxygen and index and APACHE II score of the observation group were calculated. Results: The levels of TT3, TT4 and FT3 in the improved group and the dead group were lower than those in the control group (P=0.000), but there was no significant difference between the improved group and the dead group (P>0.05), there was, however, significant difference between the dead group and the improved group (P=0.000). The level of serum TSH in the observation group was lower than that in the control group (P<0.05), and the difference was significant at different time points (P<0.001). There was an interaction between groups and time at the level of serum TSH (P<0.001). The level of serum TSH in the observation group was lower than that in the control group (P<0.05). There was no significant difference in serum TSH level between the TWO groups (P>0.05), but there was significant difference at different time points (P<0.001); however, there was no interaction between groups and time at serum TSH level (P>0.05). There was no significant difference in TSH levels between the non-respiratory failure, ape I respiratory failure and type II respiratory failure groups (P>0.05), there was a significant difference at different time points (P<0.001), but no interaction between groups and tune at the level of serum TSH (P>0.05). In the observation group, compared with the improvement group, the oxygenation index decreased significantly and,APACHE II score increased significantly in the death group (P=0.000). TT3, oxygenation index and APACHE II score were independent predictors of death in AECOPD patients. Conclusion: The hypothalamus-pituitary-thyroid axis may he impaired in patients with AECOPD. In severe AECOPD patients, hypoxia and thyroid hormone levels decreased more significantly.