首发双相情感障碍躁狂发作患者垂体泌乳素和甲状腺轴的相关性研究  

Correlative Study of Anterior Pituitary-thyroid Axis and Prolactin of Patients with First-episode Bipolar Mania

作　　者：江茜茜 朱云程[1] 马小燕[1] 严文佳 曾婷 刘丽[1] 季卫东[1] JIANG Xixi ZHU Yuncheng MA Xiaoyan et al(Shanghai Changning Mental Health Center,Shanghai 200335,Chin)

机构地区：[1]上海市长宁区精神卫生中心,200335

出　　处：《中国健康心理学杂志》2017年第10期1444-1448,共5页China Journal of Health Psychology

基　　金：上海市长宁区卫生和计划生育委员会课题项目(编号:20164Y013)

摘　　要：目的:寻找首发双相情感障碍躁狂发作患者的垂体前叶促甲状腺激素和泌乳素分泌水平的关系。方法:横断面研究65例首发符合ICD-10诊断标准的双相情感障碍躁狂发作病例组及年龄、性别匹配的62例对照组的垂体泌乳素、促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素、三碘甲状腺原氨酸、甲状腺素水平,探寻疾病临床特征和上述神经内分泌改变的相关性。结果:病例组与对照组比较,促甲状腺激素差异无统计学意义。按性别分组后,女性病例组与女性对照组比较,促甲状腺激素[1.94(1.23,2.89)mIU/L与1.49(1.07,2.04)mIU/L,Z=1.98]、垂体泌乳素[672.5(333.0,1 058.0)mIU/L与320.0(263.5,432.5)mIU/L,Z=3.50]升高,差异有统计学意义(P均<0.05)。相关分析发现,女性BD患者垂体泌乳素与促甲状腺激素之间存在逆函数关系(r^2=0.25,F=9.53,P<0.01),方程式y=b_0+b_1/x(b_0=291.50,b_1=793.92)。结论:TSH在性别间存在的差异提示性别可能影响垂体前叶激素分泌的代偿功能。女性患者垂体泌乳素、促甲状腺激素分泌增加可能与双相情感障碍躁狂期发病有关,但二者分泌可能存在倒数关系,男性患者未发现上述现象。Objective：To find out the interaction between TSH and PRL hormones secreted by anterior pituitary function with first-episode bipolar mania.Methods：The present cross-sectional study was processed to test the haemoconcentrations of TSH,TT3,TT4,FT3,FT4,PRL between a total of 65 patients diagnosed first-episode bipolar disorder in manic state according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision and 62 healthy controls matched with age and gender.The correlation of pathophysiological conversions of neuroendocrine and clinical characteristics of bipolar disorder-mania was analyzed.Results：There was no statistical significance between bipolar disorder in manic state group and healthy controls in TSH（P〉0.05）.After grouped according to gender,TSH/PRL of female bipolar disorder in manic state group were higher than those in female healthy controls（Z=1.984,3.496;P〈0.05）.There was an inverse relationship between PRL and TSH of female BD-mania established in correlation analysis（r2=0.25,F=9.53,P〈0.01,y=b0＋b1/x,b0=291.50,b1=793.92）.Conclusion：The difference of TSH between gender indicate that gender factor may be impact on the compensation of hormones secreted by anterior pituitary function with bipolar disorder in manic state.The increased haemoconcentrations of TSH and PRL of female patients may be responsible for the onset of the disease and may be an inverse relationship between the two hormones.The above phenomena are not found in male patients.

关 键 词：双相情感障碍 躁狂发作期 甲状腺功能测验 垂体泌乳素 负反馈调节 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R395.4[医药卫生—临床医学]