Significance Of Thyroid Hormone And Cortisol In Asthma COPD Overlap Syndrome

Objective:The aim of the study is to investigate the correlation of thyroid hormone and cortisol levels with the severity,therapeutic effect and prognosis of Asthma COPD overlap syndrome.Methods:The serum levels of thyroid hormones and cortisols were collected from Asthma COPD overlap syndrome,acute exacerbation of chronic obstructive pulmonary diseases and bronchial asthma patients who were no primary thyroid,adrenal disease and admitted into the thrid breathing internal medicine ward of second affiliated hospital of kunming medical university from january 2017 to december 2017.Gneral clinical data,blood gas analysis,pulmonary function,pulmonary artey pressure and heart failure index also were collected.The results were compared with data in control group.The Pearson correlation analysis was used to analyse correlation.Results:1.There were 11cases(11/22,50%)in the ACOS group,17 cases(17/30,56.7%)in the AECOPD group,13 cases(13/24;54.2%)in the Asthma group,whose thyroid hormones had changes.The levels of serum TT3,FT3 were significantly lower in ACOS,AECOPD group than that in control group(P<0.01),except TSH,TT4.The levels of serum TSH,TT3,FT3,TT4,FT4 were not statistically significant in Asthma group compared with control group(P>0.05).The differences of TSH.TT3.FT3?TT4?FT4 between ACOS and AECOPD were not statistically significant(P>0.05).While the TT3?FT3 levels in Asthma group were significantly lower than those in ACOS group and AECOPD group(P<0.05).2.The levels of cortisols in ACOS group were not statistically significant compared with control group(P>0.05),but the levels in AECOPD group and Asthma group were higher than those in control group and ACOS group(P<0.05).The levels of ACTH were not statistically significant in groups.3.The levels of serum TT3,FT3 were negatively correlated with pulmonary artery pressure and NT-ProBNP,positively correlated with PaO2,FEV1%pred(P<0.05).PaCO2 had no correlation with levels of serum thyroid hormones(P>0.05).4.There are no statistical correlation between Cor,ACTH and pulmonary artery pressure,NT-ProBNP,FEV1%pred,PaO2,PaCO2,IL-6,CRP(P>0.05).5.There are no statistical correlation between thyroid hormones,cortisols and frequent acute exacerbation in ACOS group and AECOPD.Conclusion:1.The thyroid hormone levels may change in ACOS group as in AECOPD group and Asthma group,which expressed as NTIS with main decrease of T3.FT3.Changes of thyroid hormone levels depend on the severity of ACOS,which have statistical correlation with anoxia,GOLD stage,pulmonary artery pressure,cardiac insuffiency.Therefore,dynamic monitoring of thyroid function is helpful to evaluate the severity,therapeutic effect and prognosis in patients with ACOS.2.There are no hypofunction of adrenocortical anxis in ACOS?AECOPD and Asthma,on the contrary,cortisol increased in AECOPD and Asthma?The significance of cortisol in ACOS needs further study.3.There are no statistical correlation between T3,Cor and frequent acute exacerbation in ACOS group and AECOPD.