青少年双相障碍不同亚型首发患者治疗前后甲状腺功能水平的差异

目的:了解青少年双相障碍不同亚型患者的临床特征及治疗前后甲状腺功能水平的差异。方法:采用电化学发光法分别在治疗前、治疗1月后测定住院双相障碍患儿149例和50例正常青少年对照组的血清三碘甲状腺原氨酸Ttriiodothyronine,T3)、甲状腺素(Thyroxine,T4)、游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)和促甲状腺激素(Thyroid-stimulating hormone,TSH)水平,按照目前发作形式分为躁狂组49例、抑郁组80例和混合组20例,比较3组间临床特征及治疗前后甲状腺功能水平。结果:躁狂组在总病程(F=8.237,P0.001)和本次病程(F=5.228,P0.05)的时间上低于抑郁组和混合组,躁狂组非核心家庭(离异、丧偶)的比例高于抑郁组和混合组(χ~2=6.200,P0.05);混合组伴有精神病性症状的比例高于躁狂组和抑郁组(χ~2=7.449,P0.05)。躁狂组、抑郁组和混合组治疗前后的T3、T4值及治疗后的FT4值低于对照组(F=49.214,27.303,12.882,P0.001);躁狂组在治疗前的FT3值高于其他3组(F=5.512,P0.001);躁狂组治疗后的TSH值高于抑郁组和对照组,并且混合组治疗后的TSH值高于对照组(F=8.752,P0.001),差异有统计学意义。结论:青少年双相障碍不同亚型存在不同的临床特征,在治疗前后与正常青少年的比较中具有不同的甲状腺素水平。

A Comparative Study of the Clinical Features and Thyroxine Levels Between Bipolar Adolescent Patients with Different First Onset Types

Objective:To explore the differences in clinical features and thyroxine levels between bipolar adolescent patients with different first onset types.Methods:The serum triodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured using electrochemiluminescence immunoassay in 149 adolescent inpatients with bipolar disorders including 49 with bipolar mania(BM),80 with bipolar depression(BD)and 20 with bipolar mixed before and one month after treatment.To explore the differences for serum lecels of thyroid hormones between bipolar mania,bipolar depression,bipolar mixed and 50 control group.Results:The total course(F=8.237,P＜0.001)and the current course(F=5.228,P＜0.05)in mania group were significantly lower than depression group and mixed group.The proportion of non core family(divorced,wid owed)in mania group was higher than that of depression and mixed group(x2 =6.200,P＜0.05).The proportion of withing psychotic symptoms in mixed group was higher than that of depression and mania group(x2 =7.449,P＜ 0.05).T3,T4 value before and after treatment and FT4 value after treatment in bipolar disorders were lower than that of control group(F=49.214,27.303,12.882;P＜0.001).FT3 value before treatment in mania group was higher than those of the other three groups (F=5.512,P＜0.001).TSH values after treatment in mania and mixed group was higher than depression and control group(F=8.752,P＜0.001).Conclusion:Bipolar adolescent patients with different first onset types probably present different clinical fertures and thyroxine levels with difference between patients before and after treatment,and healthy adolescent(P＜0.05).