慢性心力衰竭患者甲状腺激素水平与认知功能的相关性研究

摘要

目的：探讨慢性心力衰竭（CHF）患者甲状腺激素（TH）水平与认知功能的关系。方法：便利抽取181例CHF患者，记录年龄、性别、文化程度、心衰病因、心衰病程等一般资料，测定空腹TH水平，采用蒙特利尔认知评估量表（MoCA）评估认知功能。根据MoCA评分将CHF患者分为认知功能障碍组（MoCA评分<26分）与认知功能正常组（MoCA评分≥26分），比较两组间TH水平的差异，同时探讨CHF患者TH与认知功能之间的关系。结果：CHF患者的认知功能总分为（24.99±2.81）分。认知功能障碍组比认知功能正常组血清游离三碘甲状腺原氨酸（FT3）水平低，差异有统计学意义（P<0.05）。相关分析显示：CHF患者FT3与认知功能总分、视空间与执行能力、注意力、定向得分呈正相关（P<0.05）；血清游离甲状腺素（FT4）与视空间与执行能力得分呈正相关（P<0.05）。结论：CHF患者FT3水平的降低与认知功能障碍之间存在一定的相关性。%Objective:To investigate the relationship between thyroid hormone and cognitive function in hospitalized patients with chronic heart failure(CHF). Methods:A convenience sample of 181 hospitalized patients with CHF was selected to assess cognitive function using the Montreal Cognitive Assessment(MoCA). The levels of free three iodine thyroid original acid(FT3), free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured by chemical radiation immune method. The baseline clinical data were detected, including age, sex, education level, the cause of heart failured, and the course of disease. According to the MoCA scores, CHF patients were divided into normal cognitive function group and abnormal cognitive function group, respectively. The levels of TH between two groups were compared, and the relationship between TH and cognitive function was evaluated. Results:The total scores of cognitive function in patients with CHF were (24.99±2.81)points. The levels of FT3 in patients with cognitive impairment were lower than those with normal cognitive function (P<0.05). The level of FT3 was positively associated with the score of cognitive function and cognitive domains of visuospatial/executive function, attention and orientation. The level of FT4 was positively correlated with the score of cognitive domain of visuospatial/executive function. Conclusion:The decline of FT3 is associated with cognitive impairment in patients with CHF.