老年人甲状腺激素水平与脑小血管病总负荷评分的关联分析  

Correlation between thyroid function and the total cerebral small vessel disease score in the elderly

作　　者：杜危 刘芳[1,2] 邱蕾 陈玉辉 何婧 盛爱珍 刘银红 Du Wei;Liu Fang;Qiu Lei;Chen Yuhui;He Jing;Sheng Aizhen;Liu Yinhong(Department of Neurology,Beijing Hospital,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,National Center of Gerontology,Beijing 100730,China;Department of Health Care,Beijing Hospital,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]国家老年医学中心,中国医学科学院老年医学研究院,北京医院神经内科,北京100730 [2]国家老年医学中心,中国医学科学院老年医学研究院,北京医院保健医疗部,北京100730

出　　处：《中华全科医师杂志》2025年第2期184-189,共6页Chinese Journal of General Practitioners

摘　　要：目的探讨老年人甲状腺激素水平与脑小血管病总负荷评分的关联。方法该研究为横断面研究。纳入2019年4月至2020年12月在北京医院老年医学部进行体格检查的老年人, 根据脑小血管病总负荷评分分为5组, 即脑小血管病总负荷评分0、1、2、3和4分组。通过体检报告及门诊病历收集入选者的一般临床资料。所有入选者均完成3T头部磁共振成像检查, 收集相关数据, 并计算脑小血管病总负荷评分。采集入选者清晨空腹静脉血, 检测各种甲状腺激素水平。采用Spearman相关分析分析甲状腺激素水平与脑小血管病腔梗、微出血灶、脑白质高信号、血管周围间隙扩大评分以及脑小血管病总负荷评分之间的关系。进一步采用多因素有序logistic回归模型分析脑小血管病总负荷评分的关联因素。结果纳入545名老年人, 年龄(75.16±9.18)岁, 男性505名(92.7%)。其中, 脑小血管病总负荷评分0分组207名(38.0%)、1分组182名(33.4%)、2分组99名(18.2%)、3分组41名(7.5%)、4分组16例(2.9%), 各组人群间年龄、空腹血糖、收缩压、三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)以及高血压患者占比差异均有统计学意义(均P<0.05)。Spearman相关分析结果显示TT3、FT3与脑小血管病总负荷评分呈负相关(r值分别为-0.138、-0.213, 均P<0.05)。多因素有序logistic回归分析结果显示, 年龄与脑小血管病总负荷评分呈独立正向关联(OR=1.139, 95%CI:1.087~1.193, P<0.001), FT3与脑小血管病总负荷评分呈独立负向关联(OR=0.331, 95%CI:0.118~0.929, P=0.009)。结论在老年人群中FT3与脑小血管病总负荷评分呈独立负向关联。ObjectiveTo investigate the correlation between thyroid function and the total cerebral small vessel disease score in the elderly.MethodsThis cross-sectional study included elderly people who underwent physical examinations at the Geriatrics Department of Beijing Hospital from April 2019 to December 2020.Participants were devided into 5 groups based on the total score of cerebral small vessel disease:0,1,2,3,and 4.General clinical data were collected through physical examination reports and outpatient medical records.All participants underwent a 3T brain magnetic resonance imaging(MRI),scan and data were collected to calculate the total cerebral small vessel disease score.Fasting venous blood samples were taken in the morning to measure thyroid hormone levels.Relationships between thyroid hormone levels and lacunar infarcts,microbleeds,white matter hyperintensities(WMH),enlarged perivascular spaces,and total cerebral small vessel disease score were analyzed using Spearman correlation.Multivariate ordinal logistic regression was also used to analyze factors associated with total cerebral small vessel disease score.ResultsA total of 545 elderly individuals were included,with a mean age of(75.16±9.18)years,and 505(92.7%)were male.The number of subjects with a total cerebral small vessel disease score of 0 were 207(38.0%),1 were 182(33.4%),2 were 99(18.2%),3 were 41(7.5%),and 4 were 16(2.9%).Statistical significant differences were found in age,fasting blood glucose,systolic blood pressure,triiodothyronine(TT3),free triiodothyronine(FT3),and the proportion of hypertensive patients among the groups(all P<0.05).Spearman correlation analysis showed that TT3(r=-0.138,P=0.001)and FT3(r=-0.213,P<0.001)were negatively correlated with total cerebral small vessel disease score.Multivariate ordinal logistic regression analysis revealed that age was independently and positively associated with total cerebral small vessel disease score(OR=1.139,95%CI:1.087-1.193,P<0.001),while FT3 was independently and negatively associated wit

关 键 词：脑血管病 甲状腺激素类 老年人 

分 类 号：R54[医药卫生—心血管疾病]