原发甲状腺功能减退症患者认知功能损伤的研究

目的 探讨原发甲状腺功能减退症患者认知损害的特点.方法 原发性甲状腺功能减退(甲减)患者60例,与同年龄同文化程度同性别正常人匹配共60人,进行神经心理学检测.结果 轻度甲减组患者(亚临床甲减组)其词语学习能力、图像记忆、复杂图形记忆,图形延迟记忆及数字顺背倒背,词语流畅性,连线A连线B有明显差别(6.0±1.6对7.6±1.1,7.3±1.4对8.6±1.1,9.1±1.9对10.0±0.1,6.7±1.4对9.1±1.2,11.4±2.5对13.3±1.5,11.3±2.2对12.8±1.5,8.0±1.8对9.2±0.8,5.0±1.6对6.7±1.6,12.5±3.8对15.7±2.0,61.1±32.5对41.9±10.6,82.0±40.2对43.2±14.5,均P＜0.05).中度甲减患者组重度甲减组还有复杂图形复制、钟表、摆积木实验,数字符号实验均有明显差异(26.2±5.0对29.4±4.7,6.3±1.5对6.8±1.4,8.9±2.2对9.9±0.2,28.7±9.7对37.0±6.0,6.4±1.1对9.4-1.3,8.5±1.0对9.4±0.6,11.9±3.0对12.9±1.7,8.1±1.8对9.5±1.1,5.1±1.7对6.6±1.5,11.4±2.9对15.1±2.4,55.1±12.2对41.0±11.6,均P＜0.05).结论 甲状腺激素水平变化伴随着认知功能损害程度的改变,说明认知功能对甲状腺激素的强烈依赖性.

Cognitive impairment caused by primary hypothyroidism

Objective To investigate the neuropsychological characteristics of primary hypothyroidism.Method Sixty patients with primary hypothyroidism were enrolled and 60 euthyroid subjects with age-,gender-,and education-matched served as control.Neuropsychological parameters were determined in all the participants.Result The word list learning,figure recall,picture recall,verbal fluency,digit span,and trail making A and B in subclinical hypothyroid patients were impaired as compared with the control (6.0± 1.6 vs 7.6± 1.1,7.3± 1.4 vs 8.6±1.1,9.1±1.9 vs 10.0±0.1,6.7±1.4 vs 9.1±1.2,11.4±2.5 vs 13.3±1.5,11.3±2.2 vs 12.8±1.5,8.0±1.8 vs 9.2±0.8,5.0±1.6 vs 6.7±1.6,12.5±3.8 vs 15.7±2.0,61.1±32.5 vs 41.9±10.6,82.0±40.2 vs 43.2±14.5,all P＜0.05 ).Neuropsychological dysfunctions in all 11 tests were found among moderate and severe hypothyroid patients(26.2±5.0 vs 29.4±4.7,6.3±1.5 vs 6.8±1.4,8.9±2.2 vs 9.9±0.2,28.7±9.7 vs 37.0±6.0,6.4±1.1 vs 9.4±1.3,8.5±1.0 vs 9.4±0.6,11.9±3.0 vs12.9±1.7,8.1±1.8 vs 9.5±1.1,5.1±1.7 vs 6.6±1.5,11.4±2.9 vs 15.1±2.4,55.1±12.2 vs 41.0±11.6,all P＜0.05).Conclusion The severity of cognitive impairment is accompanied with the decrease of thyroid function,it suggests that the cognitive function must depend on the normal levels of thyroid hormones.