脑卒中后抑郁患者甲状腺功能动态变化及临床意义

目的 探讨脑卒中后抑郁(PSD)患者的甲状腺功能动态变化及临床意义.方法 采用抑郁自评量表将62例发病在24 h以内的急性脑梗死患者分为单纯脑梗死组(CI组)和PSD组,分别在入院第2天、第7天、第14天及第21天测定游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺素(TSH )水平.结果 ①入院第2天、第7天、第14天及第21天PSD组FT3水平均低于同期CI组.2组患者入院第7天FT3水平[分别为(2.04±0.53)ng/ml,(1.43±0.91)ng/ml]较入院第2天[分别为(1.28±0.19)ng/ml,(1.07±0.37)ng/ml]显著升高( P <0.05);入院第14天、第21天,PSD组FT3水平继续增加,CI组而与第7天差异不明显.②入院第2天、第7天PSD组FT4水平高于同期CI组.2组患者入院第14天的FT4水平[分别为(1.52±0.18)pg/ml,(1.57±0.31)pg/ml]均较第7天[分别为(2.09±0.26)pg/ml,(2.28±0.38)pg/ml]明显下降( P <0.05).③入院第2天PSD组TSH水平低于CI组(P <0.05).结论 下丘脑-垂体-甲状腺轴功能变化在PSD发病机制中起重要作用.

Dynamic changes of thyroid function in patients with post-stroke depression and its clinical significance

Objective To investigate the clinical significances of thyroid function changes in patients with post-stroke depression(PSD). Methods Sixty two cases with acute cerebral infarction (CI) were stratified into two groups by Zung self-rating depression scale, single cerebral infarct patients group (CI group) and PSD group. Serum levels of FT3, FT4 and TSH of the patients were detected on 2 days,7days,14 days and 21days after admission. Results ①On each time point after admission, FT3 levels in PSD group were lower than those in CI group. FT3 levels in the two groups on the 7 days were higher than those on 2 days(2.04±0.53 vs 1.28±0.19, 1.43±0.91 vs 1.07±0.37, P <0.05).On the 14 and 21 days, levels of FT3 in the PSD group were continuously increased.②On the 2 days and 7 days after admission, FT4 levels in PSD group were higher than those in CI group. FT4 levels in the two groups on the 14 days were lower than those on 7 days(1.52±0.18 vs 2.09±0.26, 1.57±0.31 vs 2.28±0.38, P <0.05). ③On the 2 days after admission,the TSH level in the PSD group were lower than that in CI group(2.02±0.36 vs 2.27±0.49,P <0.05). Conclusion The results indicated that the hypothalamic-pituitary-thyroid axis plays important role in the pathogenesis of PSD.