甲状腺功能亢进症患者注意网络的研究

Study of attention networks in hyperthyroid patients

目的研究甲状腺功能亢进症（甲亢）的注意网络状况，探讨甲亢患者注意缺陷的特征以及可能机制。方法运用注意网络测试（attention networks test，ANT），对确诊的34例甲亢患者和33名正常对照进行注意网络检查。结果（1）甲亢患者组警觉网络时间、定向网络时间[分别为（20．00±22．47）ms，（35．26±22．65）ms]，较对照组[分别为（35．70±17．62）ms，（50．61±23．66）ms]明显缩短。差异有统计学意义（P〈0．01）。患者执行控制网络时间[（116．71±40．36）ms]，较对照组[（93．00±29．34）ms]明显延长，差异有统计学意义（P〈0．01）。（2）执行功能网络效率与三碘甲状腺原氨酸（T3）、甲状腺素（T4）水平呈显著正相关（r=0．350，P〈0．05；r=0．417，P〈0．05），与促甲状腺激素（TSH）水平无相关性（P〉0．05）。警觉、定向网络与T3、T4、TSH水平均无相关性（P〉0．05）。结论甲亢患者的警觉、定向和执行控制网络均受损，提示甲亢患者可能存在广泛的注意功能损害。其中执行控制网络功能随着T3、T4水平增高而逐渐减退。

Objective To investigate the characteristics and plausible mechanisms of attention network impairments in hyperthyroid patients. Methods 34 hypertyroid patients and 33 normal controls performed the attention network test （ANT） ,which was used for assessing three components of attentional networks including alerting, orienting, and executive control. Results The mean scores for alerting and orienting networks were significantly shorter （ P 〈 0.01 ） in hyperthyroid patients （ respectively, （20.00 ± 22.47 ） ms, （ 35.26 ± 22.65 ） ms） than those in normal controls （ respectively, （ 35.70 ± 17.62 ） ms, （ 50.61 ± 23.66 ） ms）. The mean reaction time for executive control network was significantly longer（ P 〈 0.01 ） in hyperthyroid patients （ （ 116.71 ± 40.36 ） ms ） than those in controls （ （ 93.00 ± 29.34 ） ms）. Tfiiodothyronine （ T3 ） and thyroxine （ T4 ） were positively correlated with the scores for executive control network （ respectively, r= 0. 350, P〈 0.05 ; r= 0.417, P〈 0.05 ） in hyperthyroid patients, whereas no relationship was found between thyroid stimulating hormone（TSH） and the value of executive control network. T3 ,T4 and TSH were not correlated with the value of alerting and orienting network in hyperthyroid patients. Conclusion Hypertyroid patients have extensive impairments in various kinds of attentional network, rather than a specific deficit. The recession of executive control network accompanies with enhancement of serum levels of T3, T4 in hyperthyroid patients.