难治性抑郁症的临床特征以及甲状腺激素水平的对照研究

目的探讨难治性抑郁症的临床特征以及甲状腺激素水平。方法采用汉密尔顿抑郁量表17项版(HRSD-17)和汉密尔顿焦虑量表(HAMA)对符合《国际疾病分类(第10版)》(ICD-10)诊断标准的48例难治性抑郁症患者和54例非难治性抑郁症患者进行测评,采用放射免疫法测定两组患者血清促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平。结果难治性抑郁症组(TRD组)与非难治性抑郁症组(非TRD组)比较,起病年龄更早(16.4±3.8)岁vs.(23.6±4.3)岁],受教育年限更短(8.7±2.1)年vs.(10.6±2.3)年],本次发病病程更长(65.1±18.3)月vs.(4.9±2.5)月],HRSD-17中行为阻滞因子评分更高(8.37±2.43)分vs.(6.51±2.55)分],血清FT3水平更低(3.93±0.52)pmol/L vs.(4.21±0.49)pmol/L],差异均有统计学意义(P0.05)。结论难治性抑郁症患者单次病程长,起病早,文化水平低,阻滞症状重,血清FT3水平低。

Control study of clinical features and serum thyroid hormone levels in treatment-resistant depression

Objective To explore the clinical characteristics and thyroid hormone levels of treatment- resistant depression （TRD）. Methods 48 patients with TRD and 54 patients with non - TRD in accord with International Classification of Diseases, tenth edition（ICD- 10） diagnostic criteria were assessed with Hamilton Rating Scale for Depression- 17 item（HRSD -17） and Hamilton Anxiety Rating Scale（HAMA）. All research objects were measured for serum thyroid- stimulating hormone （TSH）, total triodothgro- nine （YY3 ）, total thyroxine （ YY4 ）, fi＇ee triodothgronine （ FT3 ） and fi＇ee thyroxine （ FT4 ） by radioimmunoassay. Results Compared with patients with non treatment - resistant depression （23.6±4.3 ） years, the patients with treatment - resistant depression （ 16.4±3.8 ） years have younger first onset age. the patients with treatment - resistant depression （ 8.7±2.1 ） years have lower education level than non treatment - resistant depression（ 10.6±2.3 ） years. The patients with treatment - resistant depression （ 65.1±18.3 ） months have longer course of disease than non treatment - resistant depression （4.9±2.5） months. Behavior retarding factor in HRSD - 17 were higher in the patients with treatment - resistant depression （8.37±2.43 ） than non treatment - resistant depression （6.51±2.55 ）. The free triodothgronine of the patients with treatment - resistant depression （3.93±0.52） pmol/L were lower than non treat- ment - resistant depression（4.21±0.49） pmol/L. The differences were statistical significance between the two groups （P 〈 0.05 ）. Conclusion The patients with treatment - resistant depression have long course of disease, young first onset age,low education level, severe retardation symptoms, and low serum free triodothgronine level.