甲状腺激素替代治疗对老年SCH患者认知功能的影响

The Effect of L-T4 Replacement Therapy on Cognitive Status in Old Patients with Subclinical Hypothyroidism

目的 探讨甲状腺激素替代治疗对老年原发性亚临床型甲状腺功能减退症（SCH）患者认知功能的影响。方法选择临床确诊的老年SCH患者64例，采用左甲状腺素替代治疗6个月，治疗前和6个月后分别应用蒙特利尔认知评估量表（MoCA）检测认知功能，同时检测甲状腺激素水平。结果48例患者中，轻度认知损伤患者（MoCA量表评分〈26分）20例，占41．7％，经左旋甲状腺素替代治疗6个月后减少到11例，占22．9％，MoCA量表评估总分显著升高（P〈0．01），记忆功能、执行功能、注意力及语言能力均有显著性改善。结论甲状腺素替代治疗可以改善老年SCH患者的轻度认知功能损伤。

Objective To investigate the effect of L-T4 replacement therapy on cognitive status in old Patients with subchnical hypothyroidism（SCH）. Methods 64 old patients with preliminarily diagnosed subclinical hypothyroidism newly were investigated with Montreal Cognitive Assessment （MoCA）, and the concentrations of FT3, FT4 and TSH were measured. After L-T4 replacement therapy for 6 months, all the indices above were remeasured and compared. Results After thyroid hormone replacement therapy for 6 months,the patients with mild cognitive impairment increased from 20 （41.7%）to11 （22. 9% ）in all patients, and the scores on MoCA full score,memory,execution function,language and attention improved more obviously than that before replacement therapy. Conclusion The treatment of thyroid hormone on the old patients with SCH had positive effects, which could improve the cognition level especially in memory, execution function ,language and attention.