老年冠心病患者抑郁情绪与血清T3、T4、TSH、rT3及同型半胱氨酸水平的性别异质性研究  

Study on gender heterogeneity of depression and serum T, T, TSH, rT and homocysteine levels in elderly patients with coronary heart disease

作　　者：李虓[1] 赵晖[1] 史丛宁 李玉文[1] 张国军[1] LI Xiao;ZHAO Hui;SHI Congning;Li Yuwen;ZHANG Guojun(Laboratory Department,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院检验科,北京100070

出　　处：《长春中医药大学学报》2020年第4期766-769,共4页Journal of Changchun University of Chinese Medicine

摘　　要：目的观察老年冠心病患者血清T3、T4、TSH、rT3及同型半胱氨酸表达水平,分析以上指标与抑郁情绪变化的性别异质性。方法根据抑郁自评量表(SDS)评分结果将老年冠心病患者分为抑郁组和非抑郁组,将抑郁组患者按照性别分为男性组和女性组,对比各组甲状腺激素及同型半胱氨酸水平。结果抑郁组TSH、rT3及Hcy水平明显高于非抑郁组(P<0.05);男性组与女性组冠心病患者SDS评分及血清Hcy比较相当(P>0.05);不同性别患者血清TSH、T3、T4及rT3比较,差异有统计学意义(P<0.05);女性冠心病患者SDS评分与TSH、rT3及Hcy存在正相关(P<0.05);男性冠心病患者SDS评分与TSH及Hcy存在正相关(P<0.05)。TSH及Hcy指标对女性老年冠心病患者的抑郁情绪具有显著正向预测力,TSH对男性老年冠心病患者的抑郁情绪具有显著正向预测力。结论老年冠心病患者血清T3、T4、TSH、rT3及Hcy水平在不同性别间存在异质性,建议诊治过程中行个性化诊疗方案。Objective To study the levels of serum T3,T4,TSH,rT3 and homocysteine in elderly patients with coronary heart disease and to analyze the gender heterogeneity between the above indexes and depression.Methods According to the results of Self-rating Depression Scale (SDS),the elderly patients with coronary heart disease were divided into depression group and non-depression group.The depression group was divided into male group and female group,and the levels of thyroid hormone and homocysteine were compared.Results The levels of TSH,rT3 and Hcy in depression group were significantly higher than those in non-depression group (P<0.05).There was no significant difference between the male group and the female group in SDS score and Hcy (P>0.05);there was significant difference in TSH,T3,T4 and rT3 between the two groups (P<0.05).There was a positive correlation between SDS score and TSH,rT3 and Hcy in female patients with coronary heart disease (P<0.05);there was a positive correlation between SDS score and TSH and Hcy in male patients with coronary heart disease (P<0.05).The indexes of TSH and Hcy had significant positive predictive power for depression of female elderly patients with coronary heart disease,and TSH had significant positive predictive power for depression of male elderly patients with coronary heart disease.Conclusion The levels of serum T3,T4,TSH,rT3 and Hcy are heterogeneous in different genders.Personalized diagnosis and treatment plan should be implemented in the process of diagnosis and treatment.

关 键 词：老年冠心病 抑郁症状 甲状腺激素 同型半胱氨酸 性别 

分 类 号：R541.4[医药卫生—心血管疾病]