摘要
目的了解新疆维吾尔族、汉族老年人轻度认知功能障碍（MCI）患者与甲状腺激素水平的变化，为MCI的早期干预提供依据。方法病例对照研究方法。2008年7月至2010年10月，对新疆地区维吾尔族、汉族≥60岁常住居民共计5398例，进行MCI的流行病学调查。根据美国精神病学会的精神障碍诊断和统计手册第4版修订版（DSM—IV）中MCI的临床诊断标准，诊断出MCI患者314例作为病例组，选取与其相匹配的正常人299名作为对照组。检测研究对象血清T3、T4及TSH水平，比较MCI组与对照组间及不同民族、性别MCI组与对照组间甲状腺激素水平的差异。使用SPSS17．0统计软件，计量资料不符合正态分布采用中位数及四分位间距描述，两组问分布位置的中位数比较采用Wilcoxon秩和检验进行分析；多因素分析中采用非条件Logistic回归分析。结果（1）血清耶水平在MCI组是1．26μg／L低于对照组的1．28μg/L（Z=-2．41，P〈0．05），血清TSH水平MCI组为5．37mIU／L高于对照组的5．00mIU／L（Z=-4．13，P〈0．05）。（2）男性血清TSH水平MCI组为5．74mlU／L高于对照组的3．96mlU／L（Z=-5．09，P〈0．05）；女性血清T3水平MCI组为1．29μg/L低于对照组的1．53μg/L（Z=-2．62，P〈0．05）。（3）汉族血清TSH水平MCI组为6．79mlU／L高于对照组的3．56mlU／L（Z=-4．95，P〈0．05）。维吾尔族血清T3水平MCI组为1．29μg／L低于对照组的1．39μg／L（Z=-2．58，P〈0．05），T4水平MCI组为82．37μg/L低于对照组的92．71μg/L（Z=-4．28，P〈0．05）。（4）MCI组维、汉比较，T4水平维吾尔族82．37μg／L高于汉族42．12μg／L（Z=-9．83，P〈0．05），TSH水平维吾尔族4．93mlU／L低于汉族6．79mlU／L（Z=-4．28，P〈0．05）。（5）经非条件Logistic回归分析高血压病、糖代谢异常、高脂血症、乃水平低为MCI的独立危险因素（OR值分别为2．014、2．466、2．096、0．470，OR的95％C1分别为1．361～2．981，1．649～3．687，1．396—3．149，0．334—0．663，P均〈0．05）。结论（1）老年人甲状腺激素的水平与MCI的发生相关，血清T3水平低对维、汉两民族MCI的发生均有影响；（2）除既往公认的高血压病、糖代谢异常、高脂血症为MCI的独立危险因素外，提示仍水平低可能也是MCI的独立危险因素之一.
Objective To investigate the level of thyroid hormone in Xinjiang Uygur and Han old people with mild cognitive dysfunction （ MCI）, and to provide basis for early intervention of MCI. Methods Case control study was carried out among 5398 residents who was above 60 years old in Xinjiang, Han and Uyghur ,from July 2008 to October 2010. According to the diagnosis of MCI by American Psychiatric Society and DSM-IV, 314 patients were diagnosed with MCI matching 299 healthy people as control group. Serum T3 （triiodothyronine）, T4 （thyroxine） and TSH （thyroid stimulating hormone） level was determined and compared between control group and MCI group with different nationalities and genders SPSS 17. 0 statistical software was used to depict median and quartile of the data, two groups of distribution between the location of the median use Wilcoxon compares the rank of testing and analysis. Results （ 1 ） the level of serum T3 in MCI group was lower than that of the control group （ 1.26 μg/L vs. 1.28 μg/L, Z = 2.41, P 〈 0. 05 ）, serum TSH level of MCI group was 5.37 mlU/L higher than that of the control group （Z = 4. 13, P 〈 0. 05 ）. （2） Male serum TSH level of MCI was 5.74 mlU/L higher than that of the control group （ Z = 5.09, P 〈 0. 05 ） . Women sermn T3 level of MCI was 1.29 μg/L lower than that of the control group 1.53 μg/L （Z = 2.62, P 〈 0. 05 ）. （ 3 ） Serum TSH level of MCI in Han nationality was 6. 79 mIU/L higher than that of the control group （ Z = 4. 95, P 〈 0. 05 ）. Serum T3 level of MCI in Uygur nationality was 1.29 trg/L lower than those of the control group 1.39 μg/L （ Z = 2. 58, P 〈 0. 05 ）, and T4 level was 82. 37 μg/L lower than that of the control group 92.71 μg/L （Z =4. 28, P 〈0. 05）. （4） Uygur＇s T4 level was 82.3 μg/L, higher than the 42. 12 μg/L in Han nationality （ Z = 9.83, P 〈 0. 05 ）, level of TSH in Uygurwith MCI was 6. 79 lower than that of the Han nationality （Z =4.28, P 〈0.05）. （5） The unconditional Logistic regression analysis showed hypertension, sugar metabolism disorders, hyperlipidemia, low level of T3 were independent risk factors for MCI （ OR values were 2. 014, 2. 466, 2. 096, 0. 470, respectively, 95% CI were 1. 361 -2. 981, 1. 649 -3. 687, 1. 396 -3. 149, 0. 334 -0. 663, respectively, P 〈 0. 05 ）. Conclusions （ 1 ） Thyroid hormone level in old people related to the occurrence of MCI ; （ 2 ） Aside recognized independent risk factors for MCI as hypertension, sugar metabolism disorders, hyperlipidemia, low T3 level may be one of the MCI independent risk factors.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2012年第10期921-925,共5页
Chinese Journal of Laboratory Medicine
基金
国家自然科学基金项目（30960402）
