甲状腺功能亢进症患者治疗前后的脑功能及脑血流动力学改变

Changes of brain function and cerebral blood flow dynamics in patients with hyperthyroidism before and after treatment

目的：探讨甲状腺功能亢进症患者治疗前后的脑功能及脑血流动力学改变。方法：对296例临床诊断甲状腺功能亢进症患者,在抗甲状腺药物或放射性^(131)I治疗前后行脑电图(EEG)检查,其中138例同时做经颅多普勒超声(TCD)检测。结果：治疗前EEG异常率68．9%(204/296),主要表现为α波频率增快,β活动增多、波幅增高,出现散在及阵发性θ、δ活动。EEG癎样放电检出率为27% (80/296)。93%(128/138)血流速度增快,76%(105/138)搏动指数增高,57%(79/138)伴有血管杂音。治疗后EEG异常率下降到15．2%,血流速度及搏动指数降低,血管杂音消失。结论：EEG和TCD是客观评定甲状腺功能亢进症患者脑功能和脑血流变化的敏感指标。脑功能和脑血流动力学的改变与甲状腺激素分泌过多有关。

Objective：To explore changes of the brain function and cerebral blood flow dynamics before and after treatment in patients with hyperthyroidism. Methods： Electroencephalogram （EEG） was measured in 296 patients with hyperthyroidism before and after treatment of antithyroid drug or radioactive^131 I. Transcranial Doppler（TCD） was simultaneously measured in 138 cases. Results： EEG abnormality rate was 68.9%（204/296） before treatment. It was noted that the a frequency and high amplitude β activity increased and sporadic or paroxysmal slow activity（θ and δ waves） occured. Eighty patients （27%） showed epileptiform discharges. TCD abnormalities including flow velocity increase （128 cases, 93% ）, the pulsatility index increases（105 cases,76%） and vascular murmur （79 cases,57%） before treatment. EEG abnormality rate was 15.2% , flow velocity and pulsatility index were reduced and the vascular murmur disappeared after treatment. Conclusions： EEG and TCD might be sensitive and objective index for evaluating the brain function and cerebral blood flow in patients with hyperthyroidism. The changes of the brain function and cerebral blood flow dynamics are closely correlated with the thyroxin hypersecretion.