多奈哌齐治疗对阿尔茨海默病患者甲状腺功能的影响

Effect of donepezil treatmwnt on thyroid function in patients with Alzhemimer′s disease

目的探讨多奈哌齐对阿尔茨海默病(AD)患者甲状腺功能的影响。方法 63例AD患者随机分为两组,分别用多奈哌齐(A组,31例)和茴拉西坦(B组,32例)治疗;另选老年健康者30例作为对照(C组)。测定治疗前后甲状腺功能,并行AD患者简易精神状况量表(MMSE)、日常生活能力量表(ADL)评估。结果治疗前,A、B组T3水平显著低于C组[(1.45±0.32)nmol/L vs.(1.76±0.95)nmol/L],TSH水平显著高于C组[(7.96±2.24)mIU/L vs.(6.79±1.89)mIU/L](P<0.05)。治疗6个月末,A组T3水平较治疗前显著升高,且高于B组(P<0.05),TSH水平显著下降,且低于B组(P<0.05)。治疗6个月末,A、B两组MMSE评分均较治疗前显著升高,且A组高于B组(P<0.05),A组ADL评分较治疗前显著降低(P<0.05)。结论甲状腺功能与AD患者认知功能障碍有关。多奈哌齐通过提高乙酰胆碱水平、上调甲状腺功能而改善AD患者的认知功能。

Objective To investigate the effect of donepezil treatmwnt on thyroid function in patients with Alzhemimer′s disease（AD）. Methods Thyroid hormones were detected in 32 AD cases treated with donepezil（group A）,31 AD cases treated with aniracetam（group B） and 30 healthy elder people（group C） before and after treatment.MMSE and ADL scores were evaluated as well. Results The levels of T3 were lower in AD patients than those in group C[（1.45±0.32）nmol/L vs.（1.76±0.95）nmol/L] and TSH levels were higher in AD patients than those in group C [（7.96±2.24）mIU/L vs.（6.79±1.89）mIU/L]（P0.05）. At the end of 6 months of treatment,the level of T3 in group A was higher than that before and that in group B（P0.05） and the level of TSH in group A was lower than that before and that in group B（P0.05）.At the end of 6 months of treatment,MMSE scores in groups of A and B were greater than those before,which were higher in group A than those in group B（P0.05）.ADL score of group A was lower at the end of 6 months of treatment than that before（P0.05）. Conclusion The thyroid function is associated with cognition function in the patients with AD.The treatment with donepezil may improve the cognition function of AD patients by elevating acetylcholine level and upregulating thyroid function.