原发性甲状腺功能减退症患者认知功能障碍的特点  

The characteristics of cognitive impairment in patients with primary hypothyroidism

作　　者：俞淼[1] 袁鹰[1] 迟松 王芳[1] 

机构地区：[1]青岛大学医学院附属医院内分泌科,青岛266003 [2]神经内科

出　　处：《中华行为医学与脑科学杂志》2013年第4期332-334,共3页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的观察原发性甲状腺功能减退症患者认知功能障碍的特点。方法选取未接受治疗的原发性甲减患者90例分为3组，其中亚临床甲减组30例，轻中症甲减组30例，重症甲减组30例以及甲功正常组30例，采用简易智力状态检查（MMSE）和蒙特利尔认知评估量表中文版（MoCA）分别对其定向力、即刻记忆、注意和计算、延迟回忆、语言、视空间及执行、命名、抽象能力等方面进行评估。各项量表得分经方差分析等统计学处理。结果亚临床甲减组、轻中症甲减组、重症甲减组MMSE总分分别为（27．53±2．16）分，（26．90±1．88）分，（24．80±2．10）分，MoCA总分分别为（23．57±3．33）分，（21．60±2．81）分，（20．53±3．03）分均明显低于正常对照组[分别为（28．23±1．33）分，（26．63±2．31）分]，均差异有统计学意义（P〈0．05）。除定向力、即刻记忆外，其他认知功能项，甲减组与对照组相比均差异有统计学意义（P〈0．05）。随着甲减严重程度的增加，甲减组逐渐出现注意力、计算力、语言力、视空间及执行力、命名力、抽象力的降低（p〈0．05），且得分逐渐降低（p〈0．05）。结论原发性甲减患者存在注意和计算、延迟回忆、语言、视空间及执行、命名、抽象力的认知功能损害。Objective To observe the characteristics of cognitive impairment in patients with primary hy- pothyroidism. Methods A total of 90 primary hypothyroidism patients untreated with thyroid hormone were select- ed. All the 90 patients were divided into subclinical hypothyroidism group, mild or moderate hypothyroidism group and serious hypothyroidism group, and 30 patients in each group. The other 30 healthy volunteers were selected as controls. Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA） were used for the testing their orientation, immediate memory, attention and calculation, delayed recalling, linguistic competence, visual space and execution, naming ability and abstracting power. One-way analysis of variance was performed to determine significant differences among four groups. Results The MMSE scores in subclinical hypothyroidism group , mild or moderate hypothyroidism group and serious hypothyroidism group（ （27.53 ± 2.16）, （26.90 ± 1.88 ）and （24.80 ± 2.10）respectively） were lower than those of the control （28.23 ± 1.33 ）. The MoCA scores of the above hypothyroidism groups （ （23.57 ± 3.33 ）, （21.60 ± 2.81 ） and （20.53 ± 3.03 ） respectively） were also lower than that of the control （26.63 ± 2.31 ） （P 〈 0.05 ）. Except for orientation and immediate memory, statistical significances of the other cognitive function were existed between hypothyroidism groups and the healthy controls （P 〈 O. 05）. With the increase in severity of hypothyroidism, the abnormality of attention, calculation,linguistic com- petence, visual space and executive ability, naming ability and abstracting power were appearing gradually in hy- pothyroidism groups（P 〈 0.05）, and the scores were low（P〈 0.05 ）. Conclusion Defects of attention and calcula- tion, delayed recalling, linguistic competence, visual space and execution, naming ability and abstracting power are existed in primary hypothyroidism patients.

关 键 词：原发性甲状腺功能减退症 认知功能障碍 亚临床甲减 

分 类 号：R581.2[医药卫生—内分泌]