老年亚临床甲状腺功能减退症患者认知功能障碍及相关因素分析

Investigation of a cognitive function impairment and its related factors in elderly patients with subclinical hypothyroidism

目的了解亚临床甲状腺功能减退（亚甲减）患者的认知功能及损害的特点。方法采用简易智力状态检查量表（MMSE）及韦氏记忆量表（WMS）测试亚甲减患者和甲状腺功能正常对照者（甲功正常）的认知功能，及亚甲减患者给予左旋-甲状腺素片（L-T4）治疗后认知功能的变化，并作相关性分析。结果在两组的生化指标对比中，各项指标差异均无统计学意义（P〉0．05）；亚甲减组治疗前后与甲功正常组，在MMSE评分中的差异无统计学意义；两组在WMS评分中，在图片回忆、联想学习、触摸、理解记忆及背数测试分值上，亚甲减组较甲功正常组差异有统计学意义（P〈0．05），提示亚甲减患者存在一定程度的认知功能障碍，主要表现在记忆力、注意力等方面。经过L-T4治疗3个月后，各项指标均有明显改善（P〈0．05）。结论亚甲减患者存在认知功能障碍，当促甲状腺素（TSH）恢复后，认知功能也有所提高。

Objective To understand the features of cognitive impairment in patients with subclinical hypothyroidism. Methods The cognitive function of the patients with subclinical hypothyroidism and the healthy controls was tested using Mini-Mental State Examination （MMSE） and Wechsler Memory Scale （WMS）. The change in cognitive function was observed and analyzed before and after L-T4 treatment. Results Fifty-seven patients with subclinical hypothyroidism and the same number of healthy controls were enrolled in this study. There were no significant differences between two groups in biochemical indexes and MMSE score （all P〉0.05）. But there were significant differences between two groups in WMS score, including pictures, memories, learning, touch, understanding memory and back several test scores （all P〈0.05）. There existed certain degree of cognitive dysfunction mainly displayed in memory, attention, etc. After three months of L-T4 treatment, all had significant improvement （all P〈0.05）. Conclusions Patients with subclinical hypothyroidism have cognitive dysfunction, when the thyroid stimulating hormone is restored to normal level, cognitive function is also improved.