甲状腺功能水平与双相情感障碍相关性的对照研究

目的 探索甲状腺功能与双相情感障碍的相关性.方法 以符合美国精神疾病分类与诊断标准第4版修订本(DSM-Ⅳ-TR)的双相情感障碍诊断标准的患者59例为研究对象,并选取41名健康人作为对照,应用酶联免疫吸附法(ELISA)分别测定所有研究对象的血清甲状腺激素水平,包括TT3、FT3、TT4、FT4及TSH.选用HAMD、HAMA及Bech-Rafaelsen躁狂量表评估患者组临床症状.结果 双相躁狂组中TT4、FT4水平明显高于对照组,FT3水平明显高于抑郁组,差异有统计学意义(P<0.01).双相抑郁组中TT3、FT3水平明显低于对照组,FT4水平则明显高于对照组,差异有统计学意义(P<0.01).按性别分层比较,女性双相躁狂组FT4水平与对照组相比明显升高,差异有统计学意义(P<0.05);女性双相抑郁组TT3明显低于对照组或双相躁狂组,FT4明显高于对照组,FT3则明显低于对照组,差异均有统计学意义(P<0.05),而男性躁狂组中仅TT4水平显著高于对照组(P<0.05).在双相抑郁患者中,HAMD总分与FT4呈负相关(r=-0.34,P=0.03).结论 双相情感障碍患者的甲状腺功能存在一定的改变,不同临床相甲状腺功能改变亦不相同,且这种变化以女性患者明显.

Association between bipolar disorder and thyroid function

Objective To explore the association between bipolar disorder and thyroid function. Methods A total of 59 bipolar disorder patients diagnosed according to DSM-Ⅳ-TR and 41 controls were in-cluded. The levels of thyroid hormone, including serum total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4) and thyroid stimulating hormone(TSH) were measured by enzyme linked immunosorbent assay. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Bech-Rafa-elsen scale (BRMS) were used to assess the clinical symptoms of the patients.Results The mania group showed significantly higher values of TT4 and FT4 than control group, and lower value of FT3 compared with depression group (P<0.01). While the depression group showed significant lower values of TT3 and FT3, and higher value of FT4 compared with control group (P<0.05). Level of FT4 was significantly higher in female mania group than control group (P<0.05). Level of TT3 was significantly lower in female depression group compared with mania group and control group(P<0.05). Female depression group showed significant higher level of FT4, and lower TT3 compared with control group (P<0.05).Only level of TT4 was significantly higher in male mania group than control group (P<0.05). In bipolar depression patients, the level of FT4 was negatively correlated with HAMD score (r=-0.34,P=0.03).Conclusions Thyroid function in patients with bipolar disorder shows certain changes. Changes in the level of thyroid hormone were different between mania patients and depression patients, especial-ly in female.