首发抑郁障碍、广泛性焦虑障碍及抑郁障碍伴焦虑患者临床特征与甲状腺激素水平的关系  

Clinical characteristics and their relationship with thyroid hormone levels in patients with first-episode depression,generalized anxiety disorder,and depressive disorder with anxiety

作　　者：翟姗姗 范昕昕 元静[1] 徐莉[1] 周芳[1] 卫芋君 张艳[1] 杨建中[1] ZHAI Shan-shan;FAN Xin-xin;YUAN Jing;XU Li;ZHOU Fang;WEI Yu-jun;ZHANG Yan;YANG Jian-zhong(Department of Psychiatry,the Second Affliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院精神科,650101

出　　处：《临床精神医学杂志》2021年第6期430-433,共4页Journal of Clinical Psychiatry

基　　金：国家自然科学基金(81971288);云南省领军人才(L-201623);云南省中青年科学技术后备人才(2018HB017)。

摘　　要：目的:探讨首发抑郁障碍(MDD)、广泛性焦虑障碍(GAD)以及MDD伴焦虑患者的临床特征与甲状腺激素水平的关系。方法:采用回顾性分析方法,收集78例首发MDD患者(MDD组)、67例GAD患者(GAD组)及89例MDD伴焦虑患者(MDD伴焦虑组)的人口学资料及临床资料,包括汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评分、甲状腺激素水平,并进行比较;对患者的甲状腺激素水平与其临床特征进行相关性分析。结果:各组HAMA、HAMD总分及各项因子分比较差异有统计学意义;GAD组和MDD伴焦虑组HAMA总评分及各项因子分明显高于MDD组;MDD组和MDD伴焦虑组HAMD总评分及各项因子分明显高于GAD组(P均<0.01);各组间甲状腺激素水平及其异常的发生率比较差异无统计学意义;入组者血清三碘甲状原氨酸(T3)水平与HAMD总分、HAMA总分及其躯体化焦虑因子、精神化焦虑因子分呈负相关(P<0.05或P<0.01);血清游离甲状腺素(FT4)与HAMD中认知障碍因子分呈正相关(P<0.05)。结论:血清T3、FT4水平异常可能影响患者的抑郁、焦虑等症状的严重程度。Objective:To explore the correlation of clinical characteristics and thyroid hormone levels among first episode patients of major depressive disorder(MDD),generalized anxiety disorder(GAD),and MDD comorbid anxiety.Method:Demographic data and clinical data including the scores of Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA),and the levels of blood thyroid hormone levels in the 78 first-episode MDD patients(MDD group),67 GAD patients(GAD group)and 89 MDD with anxiety patients(MDD with anxiety group)were collected by retrospective analysis.And they were compared among the groups;meanwhile,the correlation between thyroid hormone level and clinical characteristics was analyzed.Results:The total scores of HAMA and HAMD and the factor scores of the groups were statistically different.The total HAMA scores and factor scores of GAD and MDD with anxiety group were all higher than those in MDD group;the total HAMD scores and factor scores in MDD and MDD with anxiety group were both higher than those in GAD group(P<0.01);there was no statistically significant difference in the thyroid hormone level and the incidence of abnormal secretion among the groups;T3 was negatively correlated with HAMD total score,HAMA total score,HAMA somatic anxiety factor score and HAMA psychic anxiety factor score in the groups(P<0.05 or P<0.01).FT4 was positively correlated with HAMD cognitive impairment factor score in the three groups(P<0.05).Conclusion:Abnormal serum levels of T3 and FT4 may influence the severity of depression and anxiety.

关 键 词：抑郁障碍 广泛性焦虑障碍 甲状腺激素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]