老年痴呆患者甲状腺功能与认知功能的相关性分析

Analysis on Correlation between Thyroid Function and Cognitive Function in Elderly Patients with Dementia

目的:分析老年痴呆患者甲状腺功能与认知功能的相关性。方法:选取2020年6月—2021年5月上海长宁区精神卫生中心的老年科住院老年痴呆患者90例作为研究对象,根据不同痴呆类型分为阿尔茨海默病(AD)组、血管性痴呆(VD)组、混合型痴呆(MD)组,各30例;同时选取句容市中医院同年龄段智力正常健康体验人员30例作为对照组。采用放射免疫分析法检测各组甲状腺功能,包括总三碘甲状腺原氨酸(TT3)、血清总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平,采用简易智力量表(MMSE)、日常生活能力量表(ADL)和临床痴呆评定量表(CDR)对四组研究对象进行评估。结果:AD组甲状腺功能减退症占比33%,VD组占比20%,MD组占比47%。AD、VD、MD组患者TT4低于对照组,FT4高于对照组,差异有统计学意义(P<0.05)。AD、VD、MD组MMSE评分低于对照组,ADL、CDR评分高于对照组,差异有统计学意义(P<0.05)。痴呆患者的TT4与MMSE评分呈负相关(r=-0.342,P=0.001)。结论:AD、VD、MD患者均存在甲状腺功能减退情况,三组甲状腺功能减退症患病率MD>AD>VD,甲状腺功能水平与认知功能具有相关性。

Objective:To analyze the correlation between thyroid function and cognitive function in elderly patients with dementia.Methods:From June 2020 to May 2021,90 elderly patients with dementia who were hospitalized in the Geriatric Department of Shanghai Changning District Mental Health Center were selected as the study subjects.They were divided into Alzheimer′s disease(AD)group,vascular dementia(VD)group,and mixed dementia(MD)group according to different dementia types,with 30 cases in each group.At the same time,30 people with normal intelligence in the same age who received physical examination in Jurong City Hospital of Traditional Chinese Medicine were selected as the control group.Radioimmunoassay was used to detect thyroid functions in each group,including total triiodothyronine(TT3),serum total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)levels.The subjects in the four groups were evaluated by the Mini-Mental State Examination(MMSE),Activity of Daily Living Scale(ADL)and Clinical Dementia Rating Scale(CDR).Results:Hypothyroidism accounted for 33%in the AD group,20%in the VD group and 47%in the MD group.The TT4 of patients in AD,VD and MD groups was lower than that in the control group,and FT4 in AD,VD and MD groups was higher than that in the control group,and the difference was statistically significant(P<0.05).The MMSE scores in AD,VD and MD groups were lower than those in the control group,and the scores of ADL and CDR in AD,VD and MD groups were higher than those in the control group,and the differences were statistically significant(P<0.05).TT4 in patients with dementia was negatively correlated with MMSE scores(r=-0.342,P=0.001).Conclusion:Patients with AD,VD and MD have hypothyroidism,and the prevalence of hypothyroidism in the three groups is MD>AD>VD,and the thyroid function level is correlated with cognitive function.