双相障碍抑郁发作患者甲状腺功能指标、催乳素及雌二醇变化的临床意义  

Clinical significance of changes in thyroid function,prolactin and estradiol in patients with bipolar disorder and depressive episode

作　　者：章文峰[1] 杜志明 杨晓江[3] ZHANG Wen-feng;DU Zhi-ming;YANG Xiao-jiang(Department of Integrated Traditional Chinese and Western Medicine Geriatric Psychiatry,Quanzhou Third Hospital,Quanzhou 362011,Fujian,China;The Third Ward of Department of Psychiatric,Quanzhou Third Hospital,Quanzhou 362011,Fujian,China;The Fourth Ward of Department of Psychiatric,Quanzhou Third Hospital,Quanzhou 362011,Fujian,China)

机构地区：[1]泉州市第三医院中西医结合老年精神科,福建泉州362011 [2]泉州市第三医院精神科病房三病区,福建泉州362011 [3]泉州市第三医院精神科病房四病区,福建泉州362011

出　　处：《川北医学院学报》2023年第3期386-389,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨双相障碍抑郁发作患者治疗前后甲状腺功能指标、催乳素(PRL)、雌二醇(E2)变化情况及其对疗效的预测效能。方法:根据治疗效果不同将90例双相障碍抑郁发作患者分为无效组(n=28)和有效组(n=62),比较治疗前后及不同疗效患者血清甲状腺功能指标、PRL及E2水平,筛选存在差异的指标,采用受试者工作特征(ROC)曲线评估其对双相障碍抑郁发作患者疗效的预测效能。结果:治疗后,患者促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)及E2水平高于治疗前(P<0.05);治疗前后,患者游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)及PRL水平比较,差异无统计学意义(P>0.05)。治疗后,无效组患者TSH、T3、T4及E2水平低于有效组(P<0.05);不同疗效患者FT3、FT4及PRL水平比较,差异无统计学意义(P>0.05)。经ROC分析,当TSH≤2.272μIU/mL时,预测双相障碍抑郁发作患者预后不良的灵敏度为67.7%,特异度为57.1%;当T3≤1.630 nmol/L时,灵敏度为69.4%,特异度为57.1%;当T4≤92.455 nmol/L时,灵敏度为62.9%,特异度为60.7%;当E2≤59.030 pg/mL时,灵敏度为77.4%,特异度为46.4%;四者联合预测的灵敏度为79.0%,特异度为78.6%。结论:双相障碍抑郁发作患者治疗后TSH、T3、T4及E2水平均升高,治疗无效患者上述指标升高幅度较小,四者联合可用于患者预后的辅助预测。Objective:To investigate the changes of thyroid function,prolactin(PRL)and estradiol(E2)in patients with depressive episode of bipolar disorder before and after treatment,and their predictive efficacy.Methods:90 patients with depressive episode of bipolar disorder were selected as the research objects.They were divided into ineffective group(n=28)and effective group(n=62)according to the treatment effects.The serum thyroid function indicators,PRL and E2 levels before and after treatment and patients with different curative effects were compared,and the indicators with differences were screened.The ROC curve was used to evaluate its predictive efficacy for the efficacy of patients with depressive episode of bipolar disorder.Results:After treatment,the levels of thyroid stimulating hormone(TSH),triiodothyronine(T3),thyroxine(T4)and E2 were higher than those before treatment(P<0.05).There was no significant difference in the levels of free triiodothyronine(FT3),free thyroxine(FT4)and PRL before and after treatment(P>0.05).After treatment,the levels of TSH,T3,T4 and E2 in the ineffective group were lower than those in the effective group(P<0.05).There was no significant difference in the levels of FT3,FT4 and PRL among patients with different therapeutic effects(P>0.05).According to ROC analysis,when TSH≤2.272μIU/mL,the sensitivity and specificity of predicting the poor prognosis of patients with bipolar depression were 67.7%and 57.1%,respectively.When T3≤1.630 nmol/L,the sensitivity was 69.4%,and the specificity was 57.1%,When T4≤92.455 nmol/L,the sensitivity was 62.9%,and the specificity was 60.7%.When E2≤59.030 pg/mL,the sensitivity was 77.4%,and the specificity was 46.4%.The sensitivity and specificity of the combined prediction were 79.0%and 78.6%,respectively.Conclusion:After treatment,the levels of TSH,T3,T4 and E2 in patients with depressive episode of bipolar disorder increased,but the increase of the above indicators is small in patients with ineffective treatment.The combination of the four can be

关 键 词：双相障碍抑郁发作 甲状腺功能 催乳素 雌二醇 疗效 预测效能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]