文章摘要
毕书荣 ，田玉玲 ，陈香莲 ，兰子庆.帕金森病患者甲状腺激素水平与认知功能的相关性研究[J].神经损伤功能重建,2024,(5):272-275
帕金森病患者甲状腺激素水平与认知功能的相关性研究
Correlation Between Thyroid Hormone Level and Cognitive Function in Parkinson's Disease
  
DOI：
中文关键词: 帕金森病  帕金森病痴呆  甲状腺激素  认知功能
英文关键词: Parkinson’s disease  Parkinson’s disease with dementia  thyroid hormone  cognitive function
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作者单位
毕书荣1 ，田玉玲2 ，陈香莲1 ，兰子庆1 1. 山西医科大学第 一临床医学院 2. 山西医科大学第 一医院神经内科 
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中文摘要:
      目的：比较帕金森痴呆（Parkinson’s disease with dementia，PDD）与非帕金森痴呆（Parkinson’s disease without dementia，nPDD）患者临床资料及甲状腺功能的差异性，并探讨PD患者甲状腺激素水平与不同 认知域的相关性。方法：收集38例PDD组及50例nPDD组，均完成UPDRS-Ⅲ评分、H-Y分级、MMSE、MoCA（北京版）、ADL、HAMA、HAMD量表的评估，所有参与者进行游离三碘甲腺原氨酸（FT3）、游离甲状腺 素（FT4）、促甲状腺激素（TSH）水平的测定。比较2组间一般临床资料及甲状腺激素水平的差异性，分析甲 状腺激素水平与各临床资料及不同认知域的相关性。结果：与nPDD组相比，PDD组患者的UPDRS-Ⅲ评 分更高，PDD组的左旋多巴等效日剂量更高、受教育年限时间较短，ADL、HAMA、HAMD评分均较nPDD 组更高（P＜0.05）；2组的TSH、FT3、FT4水平无明显差异（P＞0.05）。在PD患者中TSH水平与性别呈正相 关（r=0.294，P＜0.01），与HAMA评分呈负相关（r=－0.246，P＜0.05）；FT3水平与年龄（r=－0.293，P＜0.01）、 性别（r=－0.320，P＜0.01）呈负相关，与 MoCA 总分、（r=0.391，P＜0.01）、视空间与执行功能（r=0.630，P＜ 0.01）、语言（r=0.222，P＜0.05）、延迟记忆（r=0.307，P＜0.01）呈正相关。控制混杂因素变量后，多元回归分 析示FT3水平与视空间与执行功能呈正相关（P＜0.01）。结论：PDD患者较nPDD患者的受教育年限时间 更短、症状严重程度更重、左旋多巴等效日剂量更大，日常生活能力更差、焦虑抑郁程度也更高。PDD患者 和nPDD患者间的TSH、FT3、FT4水平无明显差异。PD患者低FT3水平与更差的认知功能相关，尤其是视 空间与执行功能。
英文摘要:
      To compare differences in clinical data and thyroid function between patients with Parkinson's disease with dementia (PDD) and those without dementia (nPDD), and to explore correlation between thyroid hormone levels and different cognitive domains in PD patients. Methods: Clinical and thyroid function data were collected from 38 PDD and 50 nPDD patients. All participants completed the assessments including UPDRS-Ⅲ score, H-Y staging, MMSE, MoCA (Beijing version), ADL, HAMA, and HAMD scales. The levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid hormone (TSH) were measured in all participants. The differences in general clinical data and thyroid hormone levels between the two groups were compared, and the correlation between thyroid hormone levels and clinical data and different cognitive domains was analyzed. Results: Compared to the nPDD group, patients in the PDD group had higher UPDRS-Ⅲ scores, higher equivalent daily dose of Levodopa, shorter education duration, and higher ADL, HAMA, and HAMD scores (P<0.05). There were no significant differences in TSH, FT3, and FT4 levels between PDD and nPDD patients (P>0.05). In PD patients, TSH levels were positively correlated with gender (r=0.294, P<0.01), and negatively correlated with HAMA scores (r=－0.246, P<0.05); FT3 levels were negatively correlated with age (r=－ 0.293, P<0.01) and gender (r=－ 0.320, P<0.01), and positively correlated with MoCA total score (r= 0.391, P<0.01), visuospatial and executive function (r=0.630, P<0.01), language (r=0.222, P<0.05), and delayed memory (r=0.307, P<0.01). After adjusting for confounding variables, multiple regression analysis showed that FT3 levels were positively correlated with visuospatial and executive function (P<0.01). Conclusion: PDD patients had shorter educational duration, more severe symptoms, higher equivalent daily dose of levodopa, poorer daily life abilities, and higher levels of anxiety and depression compared to nPDD patients. There were no significant differences in TSH, FT3, and FT4 levels between PDD and nPDD patients. Lower FT3 levels in PD patients were associated with worse cognitive function, particularly in visuospatial and executive function.
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