不同临床相双相障碍患者甲状腺功能的回顾性研究

目的探究双相障碍患者甲状腺功能的临床相和性别差异,以期为双相障碍的诊断和治疗提供参考。方法采用回顾性研究方法,收集河南省精神病医院2015年9月-2018年1月的住院患者甲状腺功能生化指标,包括促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4),筛选符合《国际疾病分类(第10版)》(ICD-10)诊断标准的双相障碍躁狂发作(双相躁狂)和双相障碍抑郁发作(双相抑郁)患者2207例,同期选择415例体检人员作为正常对照组,比较不同临床相和不同性别的双相障碍患者甲状腺功能的差异。结果①双相躁狂患者的T3、FT3水平高于双相抑郁患者,TSH、T4水平低于正常对照组;双相抑郁患者的TSH、T3、T4、FT3水平均低于正常对照组(P<0.05或0.01);②在双相躁狂患者中,男性T3、FT3和FT4水平高于女性,而TSH、T4水平低于女性,在双相抑郁患者中,男性T3、FT3和FT4水平高于女性,而TSH水平低于女性(P<0.05或0.01);③在男性患者中,双相躁狂患者的T3和FT3水平均高于双相抑郁患者,双相抑郁患者的T3水平低于正常对照组(P<0.05或0.01);在女性患者中,双相躁狂患者的T3和FT3水平高于双相抑郁患者,双相抑郁患者的T3、T4、FT3水平均低于正常对照组(P<0.05或0.01)。结论双相障碍患者的甲状腺功能可能存在临床相和性别的差异。

Retrospective study of thyroid function in patients with bipolar disorder at different status

Objective To explore the thyroid function in patients with bipolar disorder of different clinical phases and genders,and to provide references for clinical diagnosis and treatment.Methods A retrospective study was conducted to collect thyroid function biochemical indicators of hospitalized patients in Henan Mental Hospital from September 2015 to January 2018,including thyroid stimulating hormone(TSH),triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3)and free thyroxine(FT4).According to the diagnostic criteria of the International Classification of Diseases,tenth edition(ICD-10),a total of 2207 patients with bipolar manic episode(bipolar mania)and bipolar depressive episode(bipolar depression)were enrolled,and 415 healthy physical examinees were set as normal control group.Then the thyroid function in patients with bipolar disorder of different clinical phases and different genders were compared.Results①The levels of T3 and FT3 in bipolar mania patients were higher than those in bipolar depression patients,and the levels of TSH and T4 were lower than those in normal control group,the levels of TSH,T3,T4 and FT3 in bipolar depression patients were lower than those in normal control group(P<0.05 or 0.01).②Among bipolar mania patients,T3,FT3 and FT4 levels of the male were higher than those of the female,while TSH and T4 levels were lower than those of the female.Among bipolar depression patients,T3,FT3 and FT4 levels of the male were higher than those of the female,and TSH level was lower than that of the female(P<0.05 or 0.01).③Among male patients,the T3 and FT3 levels of bipolar mania patients were higher than those of bipolar depression patients,and the T3 levels of bipolar depression patients were lower than those of the normal control group(P<0.05 or 0.01).Among female patients,the T3 and FT3 levels of bipolar mania patients were higher than those of bipolar depression patients,and the levels of T3,T4 and FT3 in bipolar depression patients were lower than those of normal control group(P<0.05 or 0.01).Conclusion Thyroid function in patients with bipolar disorder may have clinical and gender differences.