TT3、TT4、TSH、iPTH在脑小血管病患者疗程中动态变化及意义  

Dynamic changes and significance of TT3, TT4, TSH and i PTH in patients with cerebral small vessel disease during the course of treatment

作　　者：杜洋 青绍华 DU Yang;QING Shaohua(Suining Central Hospital,Suining Sichuan 629000,China)

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《中国急救复苏与灾害医学杂志》2022年第10期1322-1326,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川省卫生和计划生育科研课题资助项目(编号:16ZD046)。

摘　　要：目的 探究脑小血管病(CSVD)患者疗程中总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、促甲状腺素(TSH)、全段甲状旁腺激素(iPTH)水平动态变化情况及临床意义。方法 选取2019年8月—2021年3月遂宁市中心医院CSVD患者95例,根据治疗2个月后疗效不同分为疗效良好组和疗效不良组,比较两组临床资料、治疗前后血清TT3、TT4、TSH、iPTH水平,分析CSVD治疗效果的影响因素,并比较两组治疗前后日常生活能力量表(ADL)、蒙特利尔认知评估量表(MOCA)评分,分析血清TT3、TT4、TSH、iPTH水平变化值与ADL、MOCA评分变化值的相关性,并分析治疗前血清TT3、TT4、TSH、iPTH预测疗效的价值。结果 疗效不良组年龄大于疗效良好组,病程长于疗效良好组(P<0.05);疗效良好组,血清TSH、iPTH水平呈逐渐降低趋势,且均低于疗效不良组(P<0.05);年龄、病程、治疗前血清TT3、TT4、TSH、iPTH组治疗前、治疗1个月、2个月后血清TT3、TT4水平呈逐渐升高趋势,且均低于疗效不良组(P<0.05);年龄、病程、治疗前血清TT3、TT4、TSH、iPTH水平均为CSVD治疗效果的影响因素(P<0.05);疗效良好组治疗前、治疗1个月、2个月后ADL、MOCA评分呈逐渐升高趋势,且均高于疗效不良组(P<0.05);CSVD患者治疗前与治疗2个月后血清TT3、TT4、TSH、iPTH水平变化值与ADL、MOCA评分变化值呈正相关(P<0.05);治疗前血清TT3、TT4、TSH、iPTH预测CSVD疗效为不良的曲线下面积(AUC)均>0.7,联合预测的AUC最大,为0.934。结论 CSVD患者疗程中血清TT3、TT4、TSH、iPTH水平的动态变化与患者日常生活能力、认知功能改善情况密切相关,且是治疗效果的影响因素,治疗前检测各指标水平可辅助预测疗效。ObjectiveTo investigate the dynamic changes of total triiodothyroxine(TT3),total thyroxine(TT4),thyroid stimulating hormone(TSH),and intact parathyroid hormone(iPTH)levels in patients with cerebral small vessel disease(CSVD)during the course of treatment and their clinical significance.The dynamic changes in the levels of total triiodothyroxine(TT3),total thyroxine(TT4),thyroid stimulating hormone(TSH)and intact parathyroid hormone(iPTH)during the course of treatment and their clinical significance.Methods95 patients with CSVD in Suining Central Hospital from August 2019 to March 2021 were selected and divided into good efficacy group and poor efficacy group according to different efficacy after 2 months of treatment,comparing clinical data,serum TT3,TT4,TSH,iPTH levels before and after treatment in both groups,analyzing the influencing factors of CSVD treatment effect,and comparing the activity of daily living scale(Activity of daily living scale(ADL)and Montreal Cognitive Assessment(MOCA)scores were compared between the two groups before and after treatment,and the correlation between the changes in serum TT3,TT4,TSH and iPTH levels and the changes in ADL and MOCA scores was analyzed,and the correlation between serum TT3,TT4,TSH and iPTH levels before and after treatment was analyzed.The value of serum TT3,TT4,TSH,and iPTH in predicting the efficacy of treatment.ResultsIn the group with poor efficacy,the age was older than that in the group with good efficacy,and the disease duration was longer than that in the group with good efficacy(P<0.05);in the group with good efficacy,the serum TSH and iPTH levels showed a gradual decrease,and they were all lower than those in the group with poor efficacy(P<0.05);the serum TT3,TT4,TSH and iPTH levels in the group with poor efficacy showed a gradual increase before,1 month and 2 months after treatment;the age,disease duration and serum TT3,TT4,TSH and iPTH levels before treatment were all influences on the treatment effect of CSVD(P<0.05).Age,duration of disease,serum TT3

关 键 词：脑小血管病 总三碘甲状腺原氨酸 总甲状腺素 促甲状腺素 全段甲状旁腺激素 疗效 认知功能 

分 类 号：R743[医药卫生—神经病学与精神病学]