阿尔茨海默病、血管性痴呆与甲状腺轴功能的关系

Pituitary-thyroid axis dysfunction in Alzheimer disease and Vascular dementia

目的 通过对Alzheimer痴呆 (AD)、血管性痴呆(VD)患者垂体 -甲状腺轴相关激素水平的检测 ,探讨AD、VD与垂体 -甲状腺轴功能的关系。方法 采用放射免疫分析法或免疫放射分析法检测 11例AD、2 3例VD、2 8例不伴痴呆的多发性腔隙性脑梗塞 (MCI)及 2 3例同龄健康对照组的血清TT3 、TT4、FT3 、FT4、TSH水平。结果 血清TT3 、FT3 、FT4、水平三病例组均低于对照组 ,而血清TT4、TSH值各病例组与对照组相比无差异。各病例组之间相比仅发现 :FT3 、VD组低于MCI组 ;其它检测值各组相比无差异。结论 AD、VD患者存在垂体 -甲状腺轴功能异常 ,甲状腺激素的降低可能参与了AD的病理生理过程 ,甲状腺功能状态及甲状腺激素水平可能为VD的影响因素 ;FT3 可能为缺血性脑血管病认知功能衰退的一个指标。

Objective To identify pituitary-thyroid axis function change in Alzheimer disease and Vascular dementia. Methods Serum levels of triiodothyronine (T_3), thyroxine (T_4), free T_3 (F_3) ,free T_4 (FT_4), thyroid stimulating hormone (TSH) were determined by immunoradiometric assay method for 11 patients with Alzheimer disease (AD), 23 patients with vascular dementia (VD), 28 patients with multi-cerebral-infarction (MCI) and 23 healthy controls. Results (1)Serum TT_3, FT_3, FT_4 levels in patients with AD, VD and MCI were lower than that in the control group. No significant differences were found in serum TT4 ,TSH between the three patient groups and the healthy control. (2)Among the three patient groups: there were no significant differences in serum TT_3,TT_4, FT_4 and TSH; but serum FT_3 level was lower in patients with VD as compared with MCI. Conclusions These results suggest that lower thyroid hormone might play a role in the pathophysiologic process of AD; the function state and serum hormone levels of thyroid might be one of the factors in the development of VD; serum FT_3 level could be used as a marker of cognitive decline of ischemic cerebral vascular disease.