老年合并认知功能障碍患者炎症、甲状腺激素水平特征及与认知功能障碍严重程度的相关性分析

Characteristics of inflammation and thyroid hormone levels in elderly patients with cognitive dysfunction and their correlation with the severity of cognitive dysfunction

目的分析合并认知功能障碍的老年患者炎症、甲状腺激素水平特征及与认知功能障碍严重程度的相关性。方法回顾性分析2021年2月—2023年4月于新疆维吾尔自治区人民医院收治的140例老年合并认知功能障碍患者的临床资料,根据患者蒙特利尔认知评价量表(MoCA)评分分为轻中度组(n=112)和重度组(n=28)。观察并比较2组一般临床资料[性别、年龄、体质量指数(BMI)、高血压病史、糖尿病病史、吸烟情况、饮酒情况、美国国立卫生研究院卒中量表(NIHSS)评分]、炎症相关指标[脑钠肽(BNP)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)]水平及甲状腺激素[促甲状腺激素(TSH)、甲状腺素(TT3)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]水平。通过Spearman相关性分析、Logistic回归分析并筛选老年患者重度认知功能障碍的独立危险因素。结果与轻中度组比较,重度组男性比例、平均年龄及平均NIHSS评分均升高(P<0.05);血清BNP、Hcy、CRP水平均升高(P<0.05);血清TSH水平升高(P<0.05),平均TT3、FT3水平降低(P<0.05)。Spearman相关性分析表明,老年患者男性比例、BNP、Hcy、CRP、TSH水平与重度认知功能障碍均呈正相关性(P<0.05),TT3、FT3水平与重度认知功能障碍均呈负相关性(P<0.05);多因素Logistic回归分析发现,老年患者血清BNP、Hcy、CRP、TSH水平升高及FT3水平降低是发生重度认知功能障碍的独立危险因素(P<0.05)。结论认知功能障碍的老年患者血清BNP、Hcy、CRP、TSH及FT3均可能成为评估认知功能障碍严重程度的潜在生物学指标,对判断病情、指导治疗具有一定的价值。

Objective To explore the characteristics of inflammation and thyroid hormone levels in elderly patients with cognitive dysfunction and their correlation with the severity of cognitive dysfunction.Methods The clinical data of 140 elderly patients with cognitive dysfunction admitted to People s Hospital of Xinjiang Uygur Autonomous Region from February 2021 to April 2023 were retrospectively analyzed.They were divided into mild-moderate group(n=112)and severe group(n=28)according to Montreal Cognitive Assessment(MoCA)scores.The general clinical data[gender,age,body mass index(BMI),hypertension history,diabetes history,smoking status,drinking status,and National Institutes of Health Stroke Scale(NIHSS)score],and the levels of inflammatory indicators[brain natriuretic peptide(BNP),homocysteine(Hcy),C-reactive protein(CRP)]and thyroid hormones[thyroid stimulating hormone(TSH),thyroxine(TT3),free triiodothyronine(FT3),and free thyroxine(FT4)]of the two groups were observed and compared.Spearman correlation analysis and Logistic regression analysis were used to screen independent risk factors for severe cognitive dysfunction in elderly patients.Results Compared with the mild-moderate group,the male proportion,mean age and mean NIHSS score of the severe group were higher(P<0.05);the mean levels of serum BNP,Hcy and CRP were higher(P<0.05);the mean serum TSH level was higher(P<0.05),and the mean levels of serum TT3 and FT3 were lower(P<0.05).Spearman correlation analysis showed that male proportion and the levels of BNP,Hcy,CRP and TSH were positively correlated with severe cognitive dysfunction(P<0.05),while the levels of TT3 and FT3 were negatively correlated with severe cognitive dysfunction(P<0.05).Multivariate Logistic regression analysis showed that the elevated levels of serum BNP,Hcy,CRP,TSH and the decreased level of FT3 were independent risk factors for severe cognitive dysfunction in elderly patients(P<0.05).Conclusion Serum BNP,Hcy,CRP,TSH and FT3 in elderly patients with cognitive dysfunction may be used as potential biological indicators to evaluate the severity of cognitive dysfunction,and have certain value in judging the condition of disease and guiding treatment.