摘要
目的探讨脑小血管病(CSVD)患者血清甲状腺激素水平与认知及情感障碍的相关性。方法选取CSVD患者216例,检测其血清甲状腺激素水平;应用蒙特利尔认知评估量表(MoCA)评估患者认知功能,汉密顿抑郁量表(HAMD_(24))及汉密尔顿焦虑量表(HAMA_(14))评估患者情感状况,根据结果分为认知障碍组与非认知障碍组、情感障碍组与非情感障碍组。通过单因素和多因素Logistic回归分析血清甲状腺激素水平与CSVD患者认知障碍和情感障碍的相关性。结果依据MoCA总分,216例CSVD患者分为认知障碍组144例和非认知障碍组72例;认知障碍组与非认知障碍组年龄、受教育年限、糖化血红蛋白、高密度脂蛋白、同型半胱氨酸、促甲状腺激素、游离T3水平比较差异均有统计学意义(P均<0.05)。经多因素Logistic回归分析调整混杂因素的影响后发现,年龄大、糖化血红蛋白高、同型半胱氨酸高、促甲状腺激素水平高为CSVD患者认知障碍的危险因素(P均<0.05),受教育年限>12年、高密度脂蛋白低、游离T3水平低是CSVD患者认知障碍的保护因素(P均<0.05)。依据HAMA_(14)及HAMD_(24)总分,将216例CSVD患者分为情感障碍组110例、非情感障碍组106例;情感障碍组与非情感障碍组性别、受教育年限、尿酸、游离T3、游离T4水平比较差异均有统计学意义(P均<0.05)。经多因素Logistic回归分析调整混杂因素的影响后,高游离T4水平为CSVD患者情感障碍的危险因素(P<0.05);男性、受教育年限7~12年、受教育年限>12年、低游离T3水平为CSVD患者情感障碍的保护因素(P均<0.05)。结论CSVD患者血清甲状腺激素水平与认知及情感障碍有关,其中促甲状腺激素水平升高为CSVD患者认知障碍的危险因素,游离T4水平升高为CSVD患者情感障碍的危险因素。
Objective To investigate the correlations between serum thyroid hormone level and cognitive and affec⁃tive disorders in patients with cerebral small vessel disease(CSVD).Methods A total of 216 patients with CSVD were selected.Serum thyroid hormone level was detected.Cognitive function was assessed using the Montreal Cognitive Assess⁃ment(MoCA).Affective function was assessed using 24-item Hamilton Rating Scale for Depression(HAMD_(24))and Hamil⁃ton Anxiety Scale 14 items(HAMA_(14)).According to the results,the patients were divided into the cognitive impairment group and non-cognitive impairment group,the affective disorder group and non-affective disorder group.The correlations between thyroid hormone level and cognitive impairment and affective disorders in patients with CSVD were analyzed by univariate and multivariate Logistic regression.Results According to MoCA score,216 CSVD patients were divided into cognitive impairment group(144 cases)and non-cognitive impairment group(72 cases).There were significant differ⁃ences in age,years of education,glycosylated hemoglobin,high-density lipoprotein,homocysteine,thyroid-stimulating hormone and free T3 levels between cognitive impairment group and non-cognitive impairment group(all P<0.05).After adjusting the influence of confounders by multivariate Logistic regression analysis,it was found that age,glycosylated hemoglobin,homocysteine and thyroid-stimulating hormone levels were risk factors for cognitive impairment in CSVD pa⁃tients(all P<0.05).Years of education>12 years,high-density lipoprotein and free T3 levels were protective factors for cognitive impairment in CSVD patients(all P<0.05).According to the scores of HAMA_(14) and HAMD_(24),216 CSVD patients were divided into affective disorder group(110 cases)and non-affective disorder group(106 cases).There were signifi⁃cant differences in gender,years of education,uric acid,free T3 and free T4 levels between the affective disorder group and the non-affective disorder group(all P<0.05).After adjusting the influence of confounders by multivariate Logistic re⁃gression analysis,it was found that high free T4 level was a risk factor for affective disorder in CSVD patients(P<0.05).Male,7-12 years of education,>12 years of education,and low free T3 level were protective factors for affective disorders in CSVD patients(all P<0.05).Conclusion Serum thyroid hormone levels in CSVD patients are associated with cogni⁃tive impairment and affective disorder,among which increased thyroid-stimulating hormone level is a risk factor for cogni⁃tive impairment in CSVD patients,and elevated free T4 level is a risk factor for affective disorder in CSVD patients.
作者
李丽博
智珈鑫
苑振云
韩彩莉
高雁
刘斋
LI Libo;ZHI Jiaxin;YUAN Zhenyun;HAN Caili;GAO Yan;LIU Zhai(Department of Neurology,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China)
出处
《山东医药》
CAS
2024年第4期1-6,共6页
Shandong Medical Journal
基金
河北省卫健委医学科学研究课题(20221417)
河北省重点研发计划项目(19277707D)。
关键词
脑小血管病
甲状腺激素
认知障碍
情感障碍
cerebral small vessel disease
thyroid hormone
cognitive impairment
affective disorder
