不同性别精神分裂症患者中泌乳素水平及甲状腺功能与自杀意念的关联性研究  

Correlations among prolactin levels,thyroid function and suicidal ideation in schizophrenics with different genders.

作　　者：毛俊雄 徐秋爽 马琦[3] 罗晓[1] 王茜莲 张婷婷[1] 迪丽达尔·多力坤 伊琦忠[1] MAO Junxiong;XU Qiushuang;MA Qi(Psychological Medicine Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院,新疆心理疾病临床医学研究中心,新疆维吾尔自治区乌鲁木齐830054 [2]新疆医科大学第四附属医院 [3]新疆医科大学临床医学研究院,新疆代谢性疾病重点实验室

出　　处：《精神医学杂志》2023年第2期113-117,共5页Journal of Psychiatry

基　　金：国家自然科学基金(编号:81660233);新疆维吾尔自治区自然科学基金(编号:2022D01D64)。

摘　　要：目的探讨在不同性别精神分裂症(SC)患者中泌乳素(PRL)水平及甲状腺功能与自杀意念(SI)的关联性。方法选取144例SC患者,采用阳性与阴性症状量表(PANSS)、24项汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA)对患者进行评定,依据精神检查中有无SI将患者分为SI组(28例)和非SI组(116例),搜集其一般资料并检测PRL水平和甲状腺素功能,比较组间差异并分析其与SI的相关性。在此基础上对年龄进行分层,进一步分析在不同性别人群中PRL和甲状腺功能与SI的关联。结果SI组HAMD、HAMA总分高于非SI组(P<0.01)。SI组PRL、促甲状腺激素(TSH)水平高于非SI组(P<0.05)。将患者按性别进行分层,结果显示SI组女性患者PRL水平高于非SI组女性患者(P<0.05)。回归分析结果显示,HAMD总分及血清PRL水平为SC患者SI的独立危险因素(P<0.05)。将患者按性别进行分层,结果显示在女性患者中,HAMD总分是SI的独立危险因素(P<0.01);在男性患者中,HAMD是SI的独立危险因素(P<0.01),HAMA总分为SI的保护因素(P<0.05)。结论血清泌乳素水平较高的女性精神分裂症患者更容易伴有自杀意念,在临床诊疗中应特别关注。Objective To explore the correlations among prolactin(PRL)level,thyroid function and suicidal ideation(SI)in schizophrenics(SC)with different genders.Methods A total of 144 SC patients were selected and assessed with Positive and Negative Syndrome Scale(PANSS),24-item Hamilton Depression Scale(HAMD-24)and Hamilton Anxiety Scale(HAMA).According to the presence or absence of SI in psychiatric examination,the patients were divided into SI group(28 cases)and non-SI group(116 cases).General data were collected,and PRL levels and thyroxine function were measured;their differences and correlations were analyzed.On this basis,age stratification was performed to further analyze the associations among PRL,thyroid function and SI in patients with different genders.Results The total scores of HAMD and HAMA in SI group were higher than those in non-SI group(P<0.01).The levels of PRL and TSH in SI group were higher than those in non-SI group(P<0.05).The patients were stratified by gender,and the results showed that the PRL level of females in SI group was higher than that of females in non-SI group(P<0.05).The results of regression analysis showed that the total score of HAMD and serum PRL level were independent risk factors for SI in SC patients(P<0.05).Patients were stratified by gender,and the results showed that the total score of HAMD was an independent risk factor for SI in female patients(P<0.01).In male patients,the total score of HAMD was an independent risk factor for SI(P<0.01),and the total score of HAMA was a protective factor for SI(P<0.05).Conclusion Female schizophrenics with higher serum prolactin levels are more likely to be accompanied by suicidal ideation,which should be paid special attention in clinical diagnosis and treatment.

关 键 词：精神分裂症 性别 自杀意念 泌乳素 甲状腺功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]