抑郁症患者血清甲状腺激素水平的检测及临床研究  

Detection and clinical study of serum thyroid hormone levels in patients with depression

作　　者：王祖森[1] 王小泉[2] 沈棫华 宋传福[2] 梁可美[2] 奚雷 WANG Zusen;WANG Xiaoquan;SHEN Yuhua;SONG Chuanfu;LIANG Kemei;XI Lei(Laboratory of the Fourth People's Hospital of Wuhu City,Wuhu 241000,Anhui;Department of Psychiatry,the Fourth People′s Hospital of Wuhu,Wuhu,Anhui 241000,China)

机构地区：[1]芜湖市第四人民医院检验科,安徽芜湖241000 [2]芜湖市第四人民医院精神科,安徽芜湖241000

出　　处：《国际检验医学杂志》2019年第2期149-152,共4页International Journal of Laboratory Medicine

基　　金：国家高技术研究发展计划(2014AA022304);安徽省神经精神疾病与心理健康协同创新中心2016年开放性课题(NDMHCI-16-08)

摘　　要：目的通过对抑郁症患者血清甲状腺激素水平检测分析,探讨抑郁症患者甲状腺功能变化情况及其临床意义。方法将该院精神科于2016年1月至2018年1月收治的127例抑郁症患者作为研究对象,按照发作特点,将单相抑郁症患者作为单相组(n=45),将双相抑郁症患者作为双相组(n=82)。另将在该院体检的53例健康志愿者作为对照组。收集3组的血清样本,采用化学发光免疫分析法对其血清甲状腺激素[三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)]水平进行检测,对比并分析3组间甲状腺功能变化。结果单相组T3、T4降低患者比例明显高于双相组,FT3升高患者比例明显低于双相组,FT4升高患者比例明显低于双相组,FT4降低患者比例明显高于双相组,TSH升高及TSH降低患者比例明显高于双相组,差异均有统计学意义(P<0.05)。单相组FT3水平明显低于双相组,差异有统计学意义(P<0.05);单相组的FT4水平明显低于对照组和双相组,差异均有统计学意义(P<0.05)。结论不同类型抑郁症患者甲状腺激素水平不同,其治疗方法应有所区别。单相抑郁症患者可见甲状腺功能减退,应侧重于心理治疗,而双相抑郁症患者的游离甲状腺激素水平较高,首先应注重药物治疗。ObjectiveTo investigate the changes and clinical significance of thyroid function in patients with depression by detecting serum thyroid hormone levels.MethodsTotally 127 cases of depression in the Department of Psychiatric of our hospital from January 2016 to January 2018 were collected as research objects.According to the characteristics of depression,patients with unipolar depression were selected as unipolar group(n=45),while patients with bipolar depression were selected as bipolar group(n=82).Meanwhile,53 cases of healthy volunteers underwent physical examination in the same period in our hospital were collected as control group.The serum samples of three groups were collected and the serum levels of thyroid hormones(T3,T4,FT3,FT4,TSH)were detected by chemiluminescence immunoassay.The changes of thyroid function between the three groups were compared and analyzed.ResultsThe proportion of patients with T3 and T4 decreased in unipolar group were significantly higher than those in bipolar group,and the proportion of patients with T3 increased in unipolar group was significantly lower than that in bipolar group,and the proportion of patients with FT4 decreased in unipolar group was significantly higher than that in bipolar group;and the proportion of patients with TSH increased and TSH decreased in unipolar group were significantly higher than those in bipolar group,the differences were statistically significant(P<0.05).The level of FT3 in unipolar group was significantly lower than that in bipolar group(P<0.05),while the level of FT4 in unipolar group was significantly lower than that in control group and bipolar group,and the differences were statistically significant(P<0.05).ConclusionThe level of thyroid hormone in patients with different types of depression was different,so the treatment should be distinguished.Psychological treatment should be focused on the unipolar depression patients with hypothyroidism,while attention should be paid to drug treatment for bipolar depression patients with high levels of

关 键 词：单相抑郁症 双相抑郁症 甲状腺激素 甲状腺功能 

分 类 号：R446.1[医药卫生—诊断学] R749.4[医药卫生—临床医学]