摘要
目的:分析阿尔茨海默病与甲状腺功能的关系,观察胆碱酯酶抑制剂石杉碱甲对甲状腺功能的影响并分析可能的机制。方法:阿尔茨海默病组选择2004-08/2006-01解放军总医院第一附属医院的住院及门诊患者27例,健康老龄组为健康志愿者及来本院体检的健康老年人30例。采用放射免疫分析方法,测定阿尔茨海默病患者与健康老龄组血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)的水平;将阿尔茨海默病患者随机分为石杉碱甲治疗组及吡拉西坦对照组,石杉碱甲治疗组给予石杉碱甲0.1mg,口服,2次/d;吡拉西坦对照组给予吡拉西坦1.2g,口服,3次/d。疗程6个月,在治疗前、治疗后3个月、6个月时分别测定各组甲状腺功能指标水平。结果:阿尔茨海默病组27例和健康老龄组30例均完成各项指标的测定,全部进入结果分析。①阿尔茨海默病组T3、FT3均较健康老龄组显著降低[T3(0.54±0.17),(0.79±0.19)μg/L,t=2.932,P<0.01];[FT3(1.66±0.43),(1.94±0.27)pmol/L,t=5.237,P<0.01]。②重度痴呆患者FT3水平较轻度痴呆患者明显降低[FT3(1.39±0.35),(1.96±0.43)pmol/L,t=2.977,P<0.01];血清FT3水平与痴呆程度呈显著相关(r=0.539,P<0.01)。③石杉碱甲治疗组FT3水平在治疗3月时较治疗前明显增加[(1.82±0.22),(1.67±0.32)pmol/L,t=3.489,P<0.01],治疗6月时较治疗前亦明显增加[(1.79±0.21)pmol/L,t=2.392,P<0.05]。④石杉碱甲组治疗3个月时FT3与吡拉西坦对照组同期相比明显增加[(1.82±0.22),(1.62±0.29)pmol/L,t=2.269,P<0.05],治疗6个月时与对照组同期相比各甲状腺功能指标差异无显著性意义(P>0.05)。结论:甲状腺功能与阿尔茨海默病所致认知功能障碍有关,胆碱酯酶抑制剂石杉碱甲对于认知功能的改善可能归功于通过提高乙酰胆碱的水平,上调甲状腺功能而完成。
AIM： To analyze the relationship between Alzheimer disease and thyroid function and to observe the effect and possible mechanisms of huperzine A, one of eholinesterase inhibitors （ChEIs）, on the thyroid function. METHODS： Totally 27 subjects at out-patient clinic or hospitalized at the First Affiliated Hospital, General Hospital of Chinese PLA from August 2004 to January 2006 were enrolled in the Alzheimer disease group. Thirty subjects were healthy volunteers or healthy senior persons who made body examination in this hospital as healthy senior subject group. The levels of serum triiodothyronine （T3）, tetraiodothyronine （T4）, free triiodothyronine （FT3）, free thyroxine （FT4） and thyrotropin （TSH） of all the subjects were determined with radioimmunoassay. Then the Alzheimer disease subjects were divided into two groups： huperzine A group and piacetam control group. The subjects in the huperzine A group received 0.1 mg huperzine A orally, twice a day. Those in the piacetam control group were treated with 1.2 g piacetam orally, 3 times a day. The progress was for 6 months. Thyruid hormones were conducted before and after treatment for 3 and 6 months, respectively. RESULTS： A total of 27 subjects in the Alzheimer disease group and 30 subjects in the healthy senior subject group conducted the trial and entered the result analysis. ①The levels of T3 and FT3 significantly decreased in the Alzheimer disease group as compared with the healthy senior subject group [T3（0.54±0.17）, （0.79±0.19） μg/L,t=2.932,P 〈 0.01]; [FT3（1.66±0.43）, （1.94±0.27） pmol/L,t=5.237, P 〈 0.01]. ③The level of FT3 of severe dementia subjects obviously reduced as compared with that of light dementia subjects [FT3 （1.39±0.35）, （1.96±0.43） pmol/L,t=2.977, P 〈 0.01]. Serum FT3 level had marked correlation with the dementia degree （r = 0.539, P 〈 0.01）. ④The level of FT3 in the huperzine A group significantly increased at month 3 as compared with before treatment [（1.82±0.22）, （1.67±0.32） pmol/L ,t=3.489, P 〈 0.01]. It remarkably in creased at month 6 as compared with before treatment [（ 1.79±0.21 ） pmol/L, t=2.392,P 〈 0.05]. ④FT3 level distinctly increased in the huperzine A group at month 3 as compared with piacetam control group [（1.82±0.22）, （1.62±0.29） pmol/L,t=2.269,P 〈 0.05], while there was no marked difference in each thyroid function at month 6 as compared with piacetam control group（P〉 0.05）. CONCLUSION： There has relationship between thyroid function and cognition functional disturbance induced by Alzheimer disease. The benefits of huperzine A could be possibly related to ChEIs that altered thyroid function through elevating acetylcholine.
出处
《中国临床康复》
CSCD
北大核心
2006年第22期70-72,共3页
Chinese Journal of Clinical Rehabilitation
