老年人轻度认知功能障碍与甲状腺轴功能关系的临床研究(附95例报告)

Clinical studies of the relationship between senile mild cognitive dysfunction and thyroid function:Analysis of 95 cases

目的探讨甲状腺轴功能是否可作为老年人轻度认知功能障碍的临床诊断指标。方法以简易智能精神状态量表(MMSE)对住院患者进行测试评分,随机抽取评分为27～30分的50例,作为正常组;随机抽取评分为20～26分的45例作为轻度认知功能障碍组,用微粒子免疫发光分析法测定两组患者血清中三碘甲状腺原氨酸(T3)、甲状腺素(T4)、超敏促甲状腺素(STSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)。结果轻度认知障碍组的T3和STSH检测结果明显低于正常组(P<0.01),FT3亦低于正常组(P<0.05)。T4和FT4的检测结果则两组间无显著性差异。结论甲状腺轴功能与痴呆症的发生、发展密切相关。FT3、T3和STSH可作为老年人轻度认知功能障碍的敏感诊断指标,并能对临床痴呆症的诊断、防治及科研提供帮助。

Objective Investigating whether or not the thyroid function can be a clinical index of an early stage of senile dementia namely mild cognitive dysfunction. Methods Hospital patients were graded with mini mental state examination （MMSE）, and they were divided into two groups： normal group, with 50 cases in random that were graded between 27 to 30 points; and mild cognitive dysfunctional group, with 45 cases in random that were graded between 20 to 26 points. Use micrommunoassay to assay the triiodothyronine （T3）, thyroxine （T4）, supersensitive thyroid stimulating hormone （S-TSH）, free triiodothyronine （FT3）, and free thyroxine （FT4） in the blood serums of the patients from two groups respectively. Results T3 and S-TSH in the blood serums of the mild cognitive dysfunction patients were distinctively lower than those in the blood serum of normal patients （P〈0.01）, as well as FT3 （P〈0.05）. There was no obvious distinction of T4 and FT4 levels in the blood serums from two groups. Conclusion Thyroid function is closely related to the occurrence and development of dementia. FT3, T3 and S-TSH can be a clinical index of and early stage of senile dementia and mild cognitive dysfunction, and are helpful in the clinical diagnosis, prophylaxis and treatment, and scientific research.