Study On The Correlation Between Serum IL-6, PCT, Hs-CRP And Thyroid Function Of AECOPD

Objective:To evaluate the proportion of thyroid functional status in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),To analyze the correlation between serum IL-6,PCT,hs-CRP and thyroid function in patients with AECOPD,To explore the relevant factors of thyroid dysfunction in AECOPD patients,And to evaluate the prognostic value of thyroid function in the prognosis of AECOPD patients.Methods:We collected retrospectively the clinical data of AECOPD patients hospitalized in Department Three of Respiratory and Critical Care Medicine,The Second Affiliated Hospital of Kunming Medical University from May 2017 to May 2020,who met the 2017 GOLD diagnostic criteria and were divided into normal thyroid function group and abnormal thyroid function group according to their thyroid function status.There were 114 cases of AECOPD with normal thyroid function and 43 cases of AECOPD with abnormal thyroid function.Gender,Age,weight,Height,Smoking history and the history of glucocorticoid use,BMI= weight/height2(kg/m2)were collected respectively.Laboratory data included:Thyroid stimulating hormone(TSH),Triiodothyronine(TT3),Free triiodothyronine(FT3),Tetriodothyronine(TT4),Free tetriodothyronine(FT4),white blood cells(WBC),interleukin-6(IL-6),Procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),Fibrinogen(Fib),D-dimer(D-D),Prealbumin(PAB),Albumin(ALB),Uric acid(UA),Creatinine(Cr),Triglyceride(TG),Total cholesterol(TC),Low-density lipoprotein(LDL),High-density lipoprotein(HDL),FVC,FEV1,PEF,FEV1/FVC,FEV1%Pred,PaO2,PaCO2,Pulmonary artery pressure,Ejection fraction,Right ventricular outflow tract,Right atrial diameter,Right ventricular diameter,Left atrial diameter,Left ventricular diameter.1.Statistics of thyroid functional status ratio;2.Comparing general data between the two groups;3.Comparing clinical indicators between the two groups;4.Spearman correlation analysis was used to analyze the correlation between serum IL-6,PCT and hs-CRP levels and thyroid function indicators in AECOPD patients;5.Using multifactor Logstic stepwise regression analysis to screen relevant factors for thyroid dysfunction in AECOPD patients;6.The Receiver Operating Characteristic(ROC)curve was used to evaluate the predict value of thyroid function indicators for AECOPD secondary pulmonary hypertension,pulmonary heart disease and heart failure.Results:1.27.39%of AECOPD patients were associated with thyroid dysfunction,of which 16.56%were NTIS.2.Gender,Age,BMI and smoking history were not statistically significan between two groups(P>0.05).The history of glucocorticoid use were statistically significan between two groups(P<0.05).3.WBC,IL-6,PCT,hs-CRP,D-D,NT-proBNP,Pulmonary artery pressure were significantly higher in AECOPD with abnormal thyroid function than in AECOPD with normal thyroid function group,the difference was statistically significant(P<0.05).PAB,ALB,PaO2,FVC,FEV1,PEF were significantly were significantly lower in AECOPD with abnormal thyroid function than in AECOPD with normal thyroid function group,the difference was statistically significant(P<0.05).There was no significant difference between AECOPD combined with normal thyroid function group and AECOPD with abnormal thyroid function group of UA,Cr,TC,TG,HDL,LDL,Fib,PaCO2,Ejection fraction,Right ventricular outflow tract,Right ventricular diameter,Right atrial diameter,Left ventricular diameter and Left atrial diameter(P>0.05).FEV1%Pred classification were statistically significan between two groups(P<0.05).4.Serum IL-6,PCT and hs-CRP were negatively correlated with TT3,FT3 in patients with AECOPD(P<0.05).Serum IL-6,PCT and hs-CRP were no statistically significant correlation with TSH,TT4,FT4(P>0.05).5.IL-6(OR=1.017,95%CI:1.001～1.034,P=0.038),ALB(OR=0.899,95%CI:0.816～0.989,P=0.029)and PaO2(OR=0.959,95%CI:0.928～0.990,P=0.011)were relevant factors for thyroid dysfunction in AECOPD patients.6.The ROC curves showed that the area under the curve(AUC)of TT3 to predict of AECOPD secondary pulmonary hypertension was 0.738(95%CI:0.661～0.815);The area under the curve of FT3 to predict of AECOPD secondary cor pulmonary was 0.679(95%CI:0.559～0.779);The area under the curve of TT3 to predict of AECOPD secondary the heart failure was 0.730(95%CI:0.643～0.817).Conclusion:1.Thyroid dysfunction is very common in patients with AECOPD,and should be paid more attention.2.The use of glucocorticoids may affect thyroid function in patients with AECOPD.3.Maintaining thyroid function at normal levels can improve lung function of AECOPD patients and reduce it’s severity.4.There was a negative correlation between serum IL-6,PCT,hs-CRP and thyroid function in patients with AECOPD,and TT3,FT3 levels can be reduced with the aggravation of inflammatory response.5.IL-6,ALB and PaO2 are relevant factors for thyroid dysfunction in patients with AECOPD.6.TT3 and FT3 have certain value in prognosis assessment of patients with AECOPD.