焦虑症的认知损害特征及与甲状腺功能的关系探讨

摘要

目的 探讨焦虑障碍患者认知损害特征及其与甲状腺功能、焦虑症临床特征之间的关系.方法 采用剑桥成套神经认知测试工具(CANTAB)对37例惊恐障碍或广泛性焦虑障碍患者、74例对照组进行视觉持续注意力、视觉空间认知记忆、空间工作记忆及执行功能的评估.并用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估患者的焦虑、抑郁严重程度.同时检测患者的血清甲状腺激素(TH)和促甲状腺激素(TSH)水平.结果 与对照组比较,患者的视觉持续注意力、视觉空间认知记忆、空间工作记忆及执行功能各项认知功能均较差(P < 0.05).其中空间工作记忆随着TH水平增加而降低,而认知损害与焦虑程度呈正相关.结论 惊恐障碍和广泛性焦虑障碍患者存在广泛的认知损伤,且这些损伤与TH水平相关.%Objective To explore the characteristics of cognitive impairment in patients with anxiety disorder,and to investi-gate the relationship between anxiety symptom and thyroid function.Methods The visual sustain attention,visual memory,working memory and executive function in 37 patients with panic disorder(PD) or generalized anxiety disorder(GAD) and 74 healthy controls were assessed by using the Cambridge Neuropsychological Test Automated Battery (CANTAB).At the same time,the anxiety and de-pression symptom of patients were assessed by using the Hamilton Anxiety Rating Scale (HAMA) and Hamilton depression Rating Scale (HAMD),respectively.Moreover,serum concentrations of thyroid hormones(TH) and thyroid-stimulating hormone(TSH) in all patients were tested.Results Compare to the healthy controls,the visual sustain attention,visual memory,working memory and execu-tive function in the patients were reduced(P<0.05).The cognitive impairment was positively correlated with serum TH concentrations (P<0.05) while no association between cognitive function and HAMA scores was found(P>0.05).Conclusion Patients suffering from PD or GAD has cognitive impairment in varied dimensions.In addition,some cognitive impairment was influenced by serum TH concentration.