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目的 探讨老年人血管性痴呆 (VD)与甲状腺轴功能的关系。 方法 采用放射免疫分析法检测 31例VD患者、2 2例不伴有痴呆的脑血管病 (CVD)患者及 2 2例同龄对照的血清三碘甲状腺原氨酸 (T3 )、甲状腺素 (T4 )、游离三碘甲状腺原氨酸 (FT3 )、游离甲状腺素 (FT4 )、促甲状腺素 (TSH)、反T3 (rT3 )水平。 结果 VD组血清T3 、T4 、FT3 水平较CVD组及对照组明显降低 ,分别为 (0 84±0 2 3)ng/ml、(6 9 5 6± 2 1 34 )ng/ml和 (3 2 3± 1 2 5 )fmol/ml,且FT3 降低程度与痴呆程度密切相关 (r =0 86 )。而FT4 、TSH、rT3 水平 3组间差异无显著性。 结论 卒中后出现正常甲状腺病态综合征 ,甲状腺激素的合成及外周代谢发生障碍。血清FT3 可作为认知功能衰退的一个标志 ,甲状腺的功能状态及甲状腺激素水平可能为VD的影响因素。
Objective To investigate the relationship between vascular dementia (VD) and thyroid axis function in the elderly. Methods Twenty-one patients with VD were enrolled in this study. Twenty-two patients with cerebrovascular disease (CVD) without dementia and twenty-two age-matched controls were enrolled in this study. Serum triiodothyronine (T3), thyroxine (T4) (FT3), free thyroxine (FT4), thyrotropin (TSH) and anti-T3 (rT3) levels were measured. Results Serum levels of T3, T4 and FT3 in VD group were significantly lower than those in CVD group and control group (0 84 ± 0 2 3 ng / ml, (6 9 5 6 ± 2 1 34) ng / ml and (3 2 3 ± 125) fmol / ml, and the decrease of FT3 was closely related to the degree of dementia (r = 866). The FT4, TSH, rT3 levels were no significant difference between the three groups. Conclusion Normal thyroid syndrome occurs after stroke, and the synthesis of thyroid hormones and peripheral metabolism are disturbed. Serum FT3 may serve as a marker of cognitive decline, thyroid function status and thyroid hormone levels may be the influencing factors of VD.