抑郁症共病阻塞性睡眠呼吸暂停患者下丘脑-垂体-甲状腺轴激素及下丘脑-垂体-性腺轴激素变化  

Changes of Hypothalamic-pituitary-thyroid Axis Hormone and Hypothalamic-pituitary-gonadal Axis Hormone in Patients with Depressive comorbidities Obstructive Sleep Apnea

作　　者：祁倩倩 张义[2] QI Qian-Qian;ZHANG Yi(Medical school of Shihezi University,Shihezi 832003,China;Clinical psychology department of People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi830000,China)

机构地区：[1]石河子大学医学院,新疆石河子832003 [2]新疆维吾尔自治区人民医院临床心理科,乌鲁木齐830000

出　　处：《中国药物经济学》2025年第3期33-38,共6页China Journal of Pharmaceutical Economics

摘　　要：目的探讨抑郁症共病阻塞性睡眠呼吸暂停(OSA)患者下丘脑-垂体-甲状腺(HPT)轴激素及下丘脑-垂体-性腺(HPG)轴激素的变化情况。方法应用医渡云系统筛选并最终纳入2022年9月至2024年9月在新疆维吾尔自治区人民医院临床心理科住院的首发抑郁症患者182例,根据通气指数(AHI)是否≥5,将患者分为抑郁组(92例)、共病组(90例)。筛选同期收治的OSA无抑郁症患者78例作为OSA组,在医院体检中心体检的无OSA、无抑郁症也无其他基础疾病的健康体检者48例,作为健康对照组。收集并记录所有研究对象的一般情况,包括性别、年龄、BMI、是否吸烟等信息。采集研究对象空腹静脉血5 ml,采用德国罗氏e801全自动电化学发光分析仪检测甲状腺激素,包括总甲状腺素(T_(4))、三碘甲状腺原氨酸(T_(3))、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))和促甲状腺激素(TSH),同时使用美国贝克曼DXO800全自动化学发光分析仪检测性腺激素,包括雌二醇(E2)、孕酮(P)、黄体生成素(LH)、卵泡刺激素(FSH)、泌乳素(PRL)及睾酮(T)。结果4组T_(3)水平比较差异有统计学意义(P<0.05);进一步两两比较结果显示,共病组、OSA组、抑郁组的T_(3)均低于健康组,共病组T_(3)水平低于抑郁组和OSA组,差异有统计学意义(P<0.05)。4组PRL水平比较差异有统计学意义(P<0.05);进一步两两比较结果显示,共病组、OSA组、抑郁组的PRL水平均高于健康组(P>0.05)。多因素Logistic回归分析结果显示,T_(3)是OSA共病抑郁症的保护因素,T_(3)每减少一个单位使患者共病的可能性增加0.212倍,95%CI(0.070~0.644),上述指标有统计学意义(P<0.05)。结论共病OSA影响了抑郁症患者的激素水平,主要体现在T_(3)水平下降。Objective To explore the changes of hypothalamic-pituitary-thyroid(HPT)axis hormones and hypothalamicpituitary-gonad(HPG)axis hormones in patients with depressive comorbidities obstructive sleep apnea(OSA).Methods A total of 182 patients with first-episode depression admitted to the clinical psychology Department of the People's Hospital of Xinjiang Uygur Autonomous Region from September 2022 to September 2024 were screened and finally included by the Yidu Cloud system.According to the ventilation index(AHI)≥5,the patients were divided into depression group(92 cases)and comorbid group(90cases).A total of 78 OSA patients without depression admitted during the same period were selected as the OSA group,and 48healthy subjects without OSA,depression or other underlying diseases were selected as the healthy control group.General information about all subjects was collected and recorded,including gender,age,BMI,and whether or not they smoked.5 ml of fasting venous blood of the subjects was collected and thyroid hormones,including total thyroxine(T_(4)),triiodothyronine(T_(3)),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH),were detected by German Roche e801automatic electrochemiluminescence analyzer.At the same time,the American Beckman DXO800 automatic chemiluminescence analyzer was used to detect gonadal hormones,including estradiol(E_2),progesterone(P),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL)and testosterone(T).Results There were significant differences in T_(3) levels among the 4 groups(P<0.05).Further pair comparison showed that T_(3) levels in comorbidities group,OSA group and depression group were lower than those in healthy group,and T_(3) levels in comorbidities group were lower than those in depression group and OSA group,with statistical significance(P<0.05).There were significant differences in PRL levels among the 4 groups(P<0.05).Further pairwise comparison showed that PRL levels in comorbidities group,OSA group and depression grou

关 键 词：抑郁症 阻塞性睡眠呼吸暂停 下丘脑-垂体-甲状腺轴激素 下丘脑-垂体-性腺轴激素 

分 类 号：R749.7[医药卫生—神经病学与精神病学] R749.92[医药卫生—临床医学]