【作者】 杨春红；

【导师】 肖琅；

【作者基本信息】 天津医科大学 ， 呼吸内科， 2003， 硕士

【摘要】 目的：比较呼吸衰竭患者的甲状腺激素水平及血气分析的变化，探讨氧分压和二氧化碳分压对甲状腺激素水平的影响。 方法：选择我院呼吸科、ICU住院呼吸衰竭患者70例，急性组30例，慢性组40例，健康对照组30例，于未吸氧时取桡动脉血1ml行血气分析，清晨空腹安静状态下取静脉血3ml查甲状腺功能，观察FT₃、FT₄、TT₃、TT₄和TSH的变化，分析呼吸衰竭患者PaO₂、PaCO₂和甲状腺激素的相关关系。 结果：急性、慢性呼吸衰竭组FT₃、TT₃、TT₄均明显低于健康对照组（P＜0.01），但急性呼衰组与慢性呼衰组无差别（P＞0.05）；急性呼衰组FT₄明显低于健康对照组（P＜0.05），而慢性呼衰组与健康对照组无差别；急性组、慢性组和对照组三组TSH无差别（P＞0.05）。急性呼衰组与慢性呼衰组PaO₂无差别，慢性呼衰组PaCO₂明显高于急性呼衰组。急性呼衰组患者的TT₃与PaO₂呈显著性正相关，r为0.861，P＜0.01，FT₃、FT₄、TT₄、TSH均与PaO₂无显著性相关，急性组患者的甲状腺激素水平与PaCO₂无显著性相关，P>0.05。慢性呼衰组患者FT3、呈显著性正相关，r分别为0.757、O，387、FT魂、TT。与Pa 020 .7 85，P< 0 .05;FT3、TT。与PaCO:呈显著性负相关，:分别为一0.573、一0.429，P<0.05;TT;、TSH与PaOZ、PaCOZ均无显著性相关，P>0.05。 结论:本研究表明，呼吸衰竭患者均可出现甲状腺激素水平减低，甲状腺激素的变化在一定程度上受PaO:降低、PaCO:升高的影响，血清T3、T4的测定有助于评佑呼吸衰竭病人的病情。更多还原

【Abstract】 Object: To compare measurements of thyroid function and blood gas analysis between patients with acute and chronic respiratory failure. The purpose of this study was to investigate the relation between thyroid hormones and PaO2, PaCO2. Methods : Retrospective, observational study at the medical/intensive care unit(ICU) in our hospital, 70 patient were admitted in the study. Immediately, we took blood sample for EGA without inhaled oxygen at admission, and at 8:00 hours on the subsequent day, we took blood samples for measuring serum total (TT4) and free thyroxine (FT4), total (TT3) and free tri-iodothyroxine(FT3), thyrotropin (TSH)concentrations. Results: The value of FT3, TT3,TT4 in patients with respiratory failure were showed obviously lower than control group, there were no difference between acute and chronic groups. In acute group, FT4 was lower than control group, but hadn’t difference between chronic and control groups. No differ among the three groups serum TSH existed. PaO2 did not differ in two groups, PaCO2 weresignificantly more in chronic RF group than acute RF group. PaO2 in patient with acute and chronic RF had positive relation with TT3, PaCO2 in the patients with chronic RF had a negative relation with FT3 TT3CP<0.05). TT4 and TSH in the patients with HF had no relation to PaO2 and PaCO2 (P>0.05). Conclusion: l.In patients with RF SES take place, 2.SES seems to related to the decrease of PaO2 and increase PaCO2; statistically significant positive relation between TT3 and PaO2 in patients, negative correlation between FT3) TT3 and PaCO2 in chronic RF. The fact suggests to measuring thyroid hormones concentration is useful, it can evaluate the state of illness in patients with RF.更多还原