甲状腺激素水平与司法精神医学鉴定中交通事故所致颅脑外伤患者的关系  

Analysis of the relationship between thyroid hormone levels and patients with traumatic brain injury caused by traffic accidents in forensic psychiatric identification

作　　者：蔡政忠 TSAI Cheng-chung CAI Zhengzhong;TSAI Cheng-chung(Department of Psychology,Shaoguan University,Shaoguan,Guangdong 512005,China;College of Traditional Chinese Medicine,Guangdong Pharmaceutical University,Guangzhou,Guangdong 511400,China;Krirk University,Bangkok 10220,Thailand)

机构地区：[1]韶关学院心理学系,广东韶关512005 [2]广东药科大学中药学院,广州511400 [3]泰国格乐大学,泰国曼谷10220

出　　处：《重庆医学》2024年第S01期1-5,共5页Chongqing Medical Journal

摘　　要：目的探讨甲状腺激素水平与司法精神医学鉴定中交通事故所致颅脑外伤患者的关系。方法选取2022年5月至2023年5月司法鉴定所进行司法精神医学鉴定为交通事故所致颅脑损伤且存在一定的精神障碍的92例被鉴定人为研究对象,根据其病情将其分为边缘精神障碍组(n=41)、轻度精神障碍组(n=35)、中度精神障碍组(n=10)、重度精神障碍组(n=6),另选取就诊的50例非颅脑损伤和精神障碍患者,分别分析不同程度颅脑损伤、精神障碍患者和非精神障碍患者、精神障碍不同等级患者及重度精神障碍患者存活与死亡的甲状腺激素水平、伤残鉴定结果及其与甲状腺激素、精神障碍分级的关系。结果中、重型颅脑损伤组T_(3)、FT_(3)水平均低于轻型颅脑损伤组,且3组T_(3)、FT_(3)水平均随着颅脑损伤程度的加重而呈现出明显下降趋势(P<0.05);颅脑损伤合并精神障碍组T_(3)、FT_(3)水平均较正常组低(P<0.05);轻、中、重度精神障碍组T_(3)、FT_(3)水平均低于边缘精神障碍组,且4组T_(3)、FT_(3)水平均随着精神障碍病情的加重而呈现出明显下降趋势(P<0.05);92例研究对象中,精神伤残鉴定结果为重度伤残的有4例(4.35%),中度伤残有37例(40.22%),轻度伤残有51例(55.43%);中、重度精神伤残组T_(3)、FT_(3)水平均低于轻度精神伤残组,且3组T_(3)、FT_(3)水平均随着精神伤残程度的增加而呈现出明显下降趋势(P<0.05);Ridit分析检验结果显示,精神障碍分级与颅脑损伤程度有相关性(P<0.05),精神伤残鉴定结果与颅脑损伤程度无相关性(P>0.05),与精神障碍分级之间有相关性(P<0.05)。结论甲状腺激素T_(3)、FT_(3)水平与颅脑损伤合并精神障碍、精神伤残鉴定结果存在相关性。Objective To explore the relationship between thyroid hormone level and the patients with craniocerebral trauma caused by traffic accidents in forensic psychiatric examination.Methods From May 2022 to May 2023,92 cases identified as craniocerebral injury caused by traffic accidents and with certain mental disorders were selected as research objects.According to their disease conditions,they were divided into borderline mental disorder group(n=41),mild mental disorder group(n=35),moderate mental disorder group(n=10)and severe mental disorder group(n=6).Another 50 patients with non-craniocerebral injury and mental disorder were selected.The levels of thyroid hormone in patients with different degrees of craniocerebral injury,patients with mental disorders and patients without mental disorders,patients with different grades of mental disorders and patients with severe mental disorders,disability identification results and their relationship with thyroid hormone and mental disorder grades were analyzed.Results The levels of T_(3) and FT_(3) in the moderate and severe craniocerebral injury group were lower than those in the mild craniocerebral injury group,and the levels of T_(3) and FT_(3) in the three groups showed a significant decreasing trend with the aggravation of the craniocerebral injury degree(P<0.05).The levels of T_(3) and FT_(3) in craniocerebral injury combined with mental disorders were lower than those in normal group(P<0.05).The levels of T_(3) and FT_(3) in mild,moderate and severe mental disorders were lower than those in borderline mental disorders group,and the levels of T_(3) and FT_(3) in 4 groups showed a significant decreasing trend with the aggravation of mental disorders(P<0.05).Among the 92 subjects,4 cases(4.35%)were severely disabled,37 cases(40.22%)were moderately disabled and 51 cases(55.43%)were mildly disabled.The levels of T_(3) and FT_(3) in the moderate and severe mental disability groups were lower than those in the mild mental disability group,and the levels of T_(3) and FT_(3) i

关 键 词：甲状腺激素水平 司法精神医学鉴定 精神障碍分级 交通事故 颅脑外伤 

分 类 号：R651.15[医药卫生—外科学]