成人生长激素缺乏对认知功能的影响  

The effect of adult growth hormone deficiency on cognitive function

作　　者：周慧 宋筱筱[1] 黄沛钰[2] 曾文衡[1] 沈慧玲 吴琳瑾 谷卫[1] Zhou Hui;Song Xiaoxiao;Huang Peiyu;Zeng Wenheng;Shen Huiling;Wu Linjin;Gu Wei(Department of Endocrinology,the Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,China;Department of Radiology,the Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,China;Department of Endocrinology,117 Hospital of People′s Liberation Army,Hangzhou 310013,China;Department of Endocrinology,the Second Hospital of Shaoxing City,Shaoxing 312000,China;Department of Endocrinology,Nantong Haimen People′s Hospital,Nantong 226100,China)

机构地区：[1]浙江大学医学院附属第二医院内分泌科,杭州310000 [2]浙江大学医学院附属第二医院放射科,杭州310000 [3]中国人民解放军第117医院内分泌科,杭州310013 [4]绍兴市第二人民医院内分泌科,绍兴312000 [5]南通市海门区人民医院内分泌科,南通226100

出　　处：《中华内分泌代谢杂志》2023年第3期249-255,共7页Chinese Journal of Endocrinology and Metabolism

基　　金：浙江省公益技术与政策科学应用研究(浙江省科技厅2015C33170)。

摘　　要：目的探讨成人生长激素缺乏对认知功能的影响。方法选择2017年6月至2018年6月就诊于浙江大学医学院附属第二医院内分泌科诊断为成人生长激素缺乏的垂体瘤或颅咽管瘤术后患者共19例为病例组,19名正常人作为对照组。所有成员均采用认知功能量表及脑功能磁共振检查进行评估,分析2组间数据。结果病例组1年内体重较对照组明显增加(P=0.017)。与对照组相比,病例组注意力相对不集中、记忆力有所下降(色词测试a、c、连线测试A耗时,P值分别为0.009、0.018、0.020;听觉词语学习测验N6项,P=0.008)。病例组执行功能、语言能力较对照组有所减弱(瑞文高级推理测验E1~E12,P=0.022;连线测试B耗时及1 min到达数,P值分别为0.023、0.004;符号数字转换,P=0.037;46~60 s内以及0~60 s内说出词语个数,P值分别为0.030、0.006)。病例组简明精神状态量表得分较对照组低(P=0.018)。病例组执行功能磁共振2-back任务的正确率偏低,左侧额叶激活明显减弱(P<0.005)。结论成人生长激素缺乏会增加肥胖风险,影响患者总体精神状态,导致不同程度的认知障碍。生长激素缺乏导致工作记忆减退,可能与疾病导致额叶脑组织活性下降有关。Objective To explore the effect of adult growth hormone deficiency on cognitive function in adults.Methods A total of 19 hypophyseal or craniopharyngioma patients who underwent surgical treatment and were diagnosed with adult growth hormone deficiency in Department of Endocrinolog,the Second Affiliated Hospital,School of Medicine,Zhejiang University from June 2017 to June 2018 were selected as the case group,and 19 normal people were included as the control group.All the members were assessed with the cognitive function scale and brain functional magnetic resonance examination,data between the groups were analyzed.Results The body weight within a year of case group was significantly increased than that of the control group(P=0.017).Compared with the control group,the case group was relatively inattentive and had decreased memory(Time of stroop color words test-a,test-c,and trail-making test-A,P values were 0.009,0.018,0.020 respectively;Auditory word learning test N6,P=0.008).The executive function and language ability of the case group were weakened compared with the control group(Raven′s matrices score E1-E12,P=0.022;Time cost and the number of arrivals in 1 min of connection test B,P values were 0.023,0.004;Symbol digit modalities test,P=0.037;The number of words spoken in 46-60 s and total number in 0-60 s of the case group was less than the control,P values were 0.030,0.006).The general mental state of the case group was worse than the control group(P=0.018).The accuracy of the 2-back task of the case group was significantly lower and the activation signal of the left frontal lobe in the case group was significantly weaker(P<0.005).Conclusions Adult growth hormone deficiency may increase obesity risk and have a detrimental influence on patients′overall mental health,resulting in varying degrees of cognitive impairment.Working memory impairments associated with adult growth hormone deficiency may be a result of decreased frontal lobe brain activity.

关 键 词：成人生长激素缺乏 认知功能 功能磁共振成像 

分 类 号：R749.1[医药卫生—神经病学与精神病学]