摘要
目的对首次接受药物治疗前不同程度阿尔茨海默病(AD)患者的甲状腺功能水平[总三碘甲状腺原氨酸(TT3)、血清游离三碘甲腺原氨酸(FT3)、血清总甲状腺素(TT4)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)]进行研究。方法选取2018年1月至2019年9月我院首次接受药物治疗前的AD患者129例(观察组)和健康体检者114例(对照组)为研究对象。观察组按照CDR评分分为轻度AD组(n=43)、中度AD组(n=47)、重度AD组(n=39)。采用电化学发光免疫法检测所有研究对象甲状腺激素水平。结果观察组TT3、FT3水平明显低于对照组,TT4、TSH水平明显高于对照组,差异有统计学意义(P<0.05)。不同程度AD组与对照组甲状腺激素水平比较,轻度AD组各项甲状腺激素水平与对照组比较,差异无统计学意义(P>0.05);中度AD组TT3水平低于对照组,TT4水平高于对照组,差异有统计学意义(P<0.05);重度AD组TT3水平低于对照组,TT4、FT4水平高于对照组,差异有统计学意义(P<0.05)。AD患者甲状腺激素水平与MMSE分值之间的相关性分析结果显示,TT3与MMSE分值呈正相关(r=0.295,P=0.001)。结论未经药物治疗的AD患者甲状腺激素水平与正常人存在差异,提示AD疾病本身会影响甲状腺激素水平,在中、重度的AD患者中尤为明显。AD患者随着认知功能减退,TT3水平随之下降。
Objective To study the levels of thyroid function in patients with Alzheimer′s disease(AD)in different stages before the first drug treatment,the thyroid function indexes including total triiodothyronine(TT3),serum free triiodothyronine(FT3),total serum thyroxine(TT4),serum free thyroxine(FT4)and thyroid stimulating hormone(TSH).Methods A total of 129 patients with AD in our hospital before the first drug treatment(the observation group)from January 2018 to September 2019 and 114 healthy subjects for physical examination(the control group)were selected as the research objects.According to CDR score,the observation group was divided into mild AD group(n=43),moderate AD group(n=47)and severe AD group(n=39).The levels of thyroid hormones in all objects were detected by electrochemiluminescence immunoassay.Results The levels of TT3 and FT3 in the observation group were significantly lower than those in the control group,while the levels of TT4 and TSH were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Comparison of thyroid hormone levels between different stages of AD and the control group,there was no statistically significant difference in thyroid hormone levels between the mild AD group and the control group(P>0.05).The level of TT3 in moderate AD group was lower than that in control group,TT4 level was higher than that in control group,the differences were statistically significant(P<0.05).TT3 level in severe AD group was lower than that in control group,TT4 and FT4 levels were higher than those in control group,the differences were statistically significant(P<0.05).The correlation analysis between thyroid hormone level and MMSE score in AD patients showed that there was a positive correlation between TT3 and MMSE score(r=0.295,P=0.001).Conclusion The level of thyroid hormone in AD patients without drug treatment is different from that in healthy objects,which prompts that AD will affect the level of thyroid hormone,especially in patients with moderate and severe AD.With the decrease of cognitive function,the level of TT3 decreases in patients with AD.
作者
邱聪龙
张怡
陈寿林
邵丽
梅曦
周东升
QIU Conglong;ZHANG Yi;CHEN Shoulin;SHAO Li;MEI Xi;ZHOU Dongsheng(Department of Geriatric Psychiatry,Ningbo Kangning Hospital,Ningbo315000,China)
出处
《中国现代医生》
2021年第10期1-5,共5页
China Modern Doctor
基金
浙江省基础公益研究计划项目(LQ19F010003)。
