甲状腺激素水平和抑郁症患者自杀尝试行为及自杀意念的相关性研究  

Study on the Correlation between Thyroid Hormones and Suicidal Attempts,Suicide Ideation in Patients with Depression

作　　者：张博宇 程夏龙 陈龙[1,2] 刘卉 朱春燕[1,3] 靳胜春 ZHANG Boyu;CHENG Xialong;CHEN Long;LIU Hui;ZHU Chun-yan;JIN Shengchun(School of Mental and Psychological Sciences,Anhui Medical University,Hefei 230022,China;Affiliated Psychological Hospital of Anhui Medical University,Anhui Mental Health Center,Hefei Fourth People’s Hospital,Hefei 230022,China;Hefei Comprehensive National Science Center Artifi-cial Intelligence Research Institute,Hefei 230022,China)

机构地区：[1]安徽医科大学精神卫生与心理科学学院,合肥230032 [2]安徽医科大学附属心理医院/安徽省精神卫生中心/合肥市第四人民医院,合肥230022 [3]合肥综合性国家科学中心人工智能研究院,合肥230022

出　　处：《神经损伤与功能重建》2024年第10期559-563,573,共6页Neural Injury and Functional Reconstruction

基　　金：省属高校与人工智能研究院协同创新项目(认知行为-神经影像在精神心理疾病诊断中的应用,No.GXXT-2021-003)。

摘　　要：目的:探究甲状腺激素水平与抑郁症患者自杀尝试行为、自杀意念及临床表现的关系,为临床干预提供参考依据。方法:纳入2020年1月至2023年7月于本院就诊的抑郁症患者1229例。依据现病史,将近1月内有自杀意念及行为者578例纳入自杀尝试组(尝试组),近1月内有自杀意念而无行为者306例纳入自杀意念组(意念组),近1月内无自杀行为及意念者345例纳入无自杀行为意念组(对照组)。分析3组基线资料、甲状腺激素水平,尝试组、意念组甲状腺激素水平及其与抑郁症临床症状的相关性。结果:尝试组汉密尔顿抑郁量表(HAMD)中认知障碍、绝望感因子得分明显高于意念组(均P<0.01),尝试组的认知障碍因子得分高于对照组(P<0.05);3组间血清T3、FT3、FT4水平,尝试组<意念组<对照组(均P<0.05),尝试组血清T3、FT3、FT4水平显著低于对照组(均P<0.05),意念组血清FT3水平显著低于对照组(P<0.05)。尝试组和意念组血清FT4水平与HAMD量表总分、汉密尔顿焦虑量表(HAMA)总分呈正相关(P<0.05);尝试组T3、FT3水平也与HAMD量表总分呈正相关(P<0.05)。Logistic回归显示,FT3水平和HAMD中认知障碍因子是抑郁症患者产生自杀尝试的独立危险因素(P<0.01),FT3水平和HAMD中绝望感因子是抑郁症患者出现自杀意念的独立危险因素(P<0.01)。结论:有自杀尝试及意念的抑郁症患者与无自杀尝试及意念的抑郁症患者血清T3、FT3、FT4水平存在显著性差异;自杀尝试组、自杀意念组血清FT4水平与HAMD、HAMA量表总分呈正相关;抑郁症患者中,血清FT3水平是出现自杀尝试及意念的生物学独立危险因素,HAMD评分中的认知障碍因子是出现自杀尝试的独立危险因素,绝望感因子是出现自杀意念的独立危险因素。Objective:To explore the relationship between thyroid hormone levels and suicide attempts,suicidal ideation,and clinical characteristics of patients with depression,providing a reference for clinical intervention.Methods:1229 patients with depression who received treatment in Hefei Fourth People's Hospital from January 2020 to July 2023 were recruited.Based on the medical history,578 patients with suicidal thoughts and behaviors within the past month were included in the suicide attempt group(attempt group),306 patients with suicidal thoughts without behaviors within the past month were included in the suicide ideation group(ideation group),and 345 patients without suicidal behaviors or thoughts within the past month were included in the no suicide behavior and ideation group(control group).We analyzed the baseline data of the three groups and the levels of thyroid hormones,as well as the correlations between the levels of thyroid hormones in the attempt group and ideation group and depressive clinical symptoms.Results:The HAMD cognitive impairment and hopelessness factor scores in the attempt group were significantly higher than those in the ideation group(both P<0.01),and the cognitive impairment factor score in the attempt group was higher than that in the control group(P<0.05).Among the three groups,the serum levels of T3,FT3,and FT4 were lower in the attempt group<ideation group<control group(all P<0.05),with serum T3,FT3,and FT4 levels in the attempt group being significantly lower than those in the control group(all P<0.05) serum FT3 level in the ideation group was significantly lower than that in the control group(P<0.05).Serum FT4 levels in both attempt and ideation groups correlated positively with the total scores on the HAMD and HAMA scales(P<0.05),while serum T3and FT3 levels in the attempt group also correlated positively with the total scores on the HAMD scale(P<0.05).Logistic regression showed that FT3 levels and cognitive impairment factors in HAMD were independent risk factors for suicidal attem

关 键 词：抑郁症 甲状腺激素 自杀尝试 自杀意念 临床特征 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学] R749