青年期广泛性焦虑障碍患者认知功能缺陷分析及其与相关激素水平的关系

Analysis on the cognitive dysfunction of adolescent patients with generalized anxiety disorder and the relationship with related hormones

目的探讨青年期广泛性焦虑障碍(GAD)患者认知功能缺陷变化及其与下丘脑-垂体-肾上腺(HPA)轴、下丘脑-垂体-甲状腺(HPT)轴相关激素水平的关系。方法将该院收治的80例青年期GAD患者作为研究对象(观察组),另将同期于该院进行体检的80例无GAD的健康青年人作为对照组,均进行MATRICS共识认知成套测验(MCCB)以评估认知功能,并检测血清HPA轴激素[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]和HPT轴激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]水平,比较其认知功能以及HPA轴和HPT轴激素水平,并分析青年期GAD患者MCCB认知总分与其HPA轴和HPT轴激素水平的关系。结果观察组MCCB测验中信息处理速度、注意/警觉性、工作记忆、词语学习、视觉学习、推理及问题解决、社会认知评分及认知综合分均显著低于对照组(P<0.05)。观察组血清ACTH、Cor、TSH水平均显著高于对照组(P<0.05),FT3、FT4水平低于对照组(P<0.05)。青年期GAD患者认知总分与ACTH、Cor水平均呈负相关(r=-0.635、-0.682,P<0.05),与FT3、FT4水平均呈正相关(r=0.668、0.593,P<0.5)。结论青年期GAD患者多存在认知功能缺陷,且其严重程度与ACTH、Cor、FT3、FT4水平有关。

Objective To investigate the cognitive dysfunction of adolescent patients with generalized anxiety disorder(GAD)and the relationship with the hormone concentrations of hypothalamic-pituitary-adrenal(HPA)axis and hypothalamic-pituitary-thyroid(HPT)axis.Methods 80 adolescent patients with GAD admitted to the hospital were enrolled in the study(observation group).The other 80 young healthy people without GAD who underwent physical examination in the hospital in the same period were selected as the control group.The MATRICS Consensus Cognitive Battery(MCCB)was performed to evaluate cognitive function.The levels of serum hormones[adrenocorticotropic hormone(ACTH),cortisol(Cor)]of HPA axis and hormone[thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free tetraiodothyronine(FT4)]of HPT axis were detected.The cognitive function,hormone levels of HPA axis and HPT axis were compared.The relationship between total score of MCCB and hormone levels of HPA axis,HPT axis of adolescent patients with GAD was analyzed.Results The scores of information processing speed,attention/alertness,working memory,word learning,visual learning,reasoning,problem solving and social cognition and cognitive synthesis scores in MCCB of the observation group were significantly lower than those of the control group(P<0.05).The levels of serum ACTH,Cor and TSH in the observation group were significantly higher than those in the control group(P<0.05),while the levels of FT3 and FT4 were lower than those in the control group(P<0.05).The cognitive total scores of adolescent patients with GAD were negatively correlated with levels of ACTH and Cor(r=-0.635,-0.682,P<0.05),positively correlated with levels of FT3 and FT4(r=0.668,0.593,P<0.05).Conclusion There is cognitive dysfunction in adolescent patients with GAD.The severity is related to the levels of ACTH,Cor,FT3 and FT4.