阿尔茨海默病患者甲状腺激素水平与抑郁症状及生活能力相关性研究

目的 探讨阿尔茨海默病患者甲状腺素水平与抑郁症状、生活能力、认知功能的相关性.方法 将32例伴有抑郁症状的阿尔茨海默病患者设为研究组,将27例无抑郁症状的阿尔茨海默病患者设为对照组,两组均予以阿尔茨海默病常规治疗,研究组在此基础上联合抗抑郁剂治疗,观察8周.于治疗前后采用汉密顿抑郁量表、日常生活能力量表、简易精神状态量表、长谷川痴呆量表评定患者疾病状况,同时测定甲状腺激素水平.结果 治疗前后两组甲状腺激素T4水平均在正常范围内,FT3水平均低于正常范围;研究组治疗后T4水平较治疗前有显著下降(P＜0.01),但治疗前后均显著高于对照组(P＜0.01),FT3水平治疗前后无显著变化,但显著低于对照组(P＜0.05).研究组汉密顿抑郁量表评分治疗前显著高于对照组(P＜0.01),治疗后较治疗前显著下降(P＜0.01),且与对照组差异无显著性(P＞0.05);日常生活能力量表评分治疗后较治疗前显著下降,但治疗前后均显著高于对照组(P＜0.01);简易精神状态量表及长谷川痴呆量表评分治疗前后无显著变化(P＞0.05),且与对照组差异无显著性(P＞0.05).结论阿尔茨海默病患者的甲状腺激素T4水平与抑郁症状、日常生活能力有关,FT3水平与认知功能衰退有关;抗抑郁治疗能有效降低T4水平,提高患者日常生活能力.

Thyroid hormone levels and correlated symptom in patients with Alzheimer's disease

Objective To explore correlation between thyroxine levels and depressive symptoms, living function and cognitive function in patients with Alzheimer＇s disease （AD）. Methods Thirty two AD patients with depressive symptoms were assigned to research group and 27 ones without to control group, both groups received conventional therapy, and the research were plus antidepressants for 8 weeks. Morbid states were assessed with the Hamilton Depression Scale （HAMD）, Activity of Daily Living Scale （ADL）, Mini-mental State Examination （MMSE） and Hasegava Dementia Scale （HDS） before and after treatment, thyroid hormone levels measured simultaneously. Results Both pre- and post-treatment T4 levels were within normal limits and FT3 lower than; T4 levels lowered more significantly after treatment compared with pretreatment in the research （P〈0.01）, but both pre-and post-treatment T4 levels were significantly higher in the research than in the control group （P〈0.01） ; there were no significant differences in FT3 levels between pre-and post-treatment, but FT3 levels were significantly lower in the research than in the control group （P〈0.05）. The HAMD score was signifcantly higher in the research than in the control group before treatment （P〈0.01）, that lowered more significantly after treatment in the research （P〈0.01） and had no significant difference from the control （P〉0.05） ; the ADL score lowered more significantly after treatment compared with pretreatment in the research, but both pre-and post-treatment ADL scores were significantly higher in the research than in the control （P〈0. 01） ; both the MMSE and HDS scores had no obvious changes between pre-and post-treatment in the research （P〉0.05）, and had no notable differences from control group （P〉0.05）. Conclusion Thyroid hormone levels are correlated to depressive symptoms and activity of daily living in patients with Alzheimer＇s disease, FT3 is related to cognitive function deterioration; antidepression therapy can effectively lower T4 level and improve activity of daily living.