Graves病患者抑郁状态与甲状腺激素水平关系研究

目的 探索Graves病患者抑郁状态与甲状腺激素水平的相关性。 方法 对门诊188名Graves病患者进行Zung抑郁自评量表 (SDS）问卷调查，并测定血清促甲状腺激素 (TSH）、游离三碘甲腺原氨酸 (FT3)、游离甲状腺素 (FT4）、促甲状腺激素受体抗体 (TRAb)等指标。运用Pearson相关分析和logistic回归分析患者抑郁状态的相关因素。 结果 将患者分为高FT4水平组 (56例）、正常FT4水平组 (113例）和低FT4水平组 (19例）3组，3组间抑郁状态的患病率差异无统计学意义 (P>0.05），但SDS评分差异有统计学意义 (P<0.05），高FT4水平组SDS评分最高。Pearson相关分析结果示SDS评分和FT3 ( r=0.372,P<0.001)、FT4水平 ( r=0.288,P<0.001）呈正弱相关；与血清TSH水平无关 ( r=-0.028,P=0.614)。Logistic回归分析发现TSH (P= 0.131）、FT4 (P=0.637）、FT3 (P=0.208)不是Graves病患者抑郁状态发生的独立危险因素。 结论 尽管在Graves病患者中抑郁的患病率比普通人群高，但目前并没发现抑郁状态和甲状腺激素水平有紧密的相关性。

Relationship Between Depression and Thyroid Hormone Levels in Patients with Graves Disease

Objective To explore the relationship between depression and thyroid hormone levels in Graves disease patients. Methods A total of 188 out-patients with Graves disease were enrolled in this study. All patients received the measurements of Zung Self-Rating Depression Scale (SDS) and serum thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and TSH receptor antibodies (TRAb). Results All the patients were divided into 3 groups: high FT4 level group （n=65）, normal FT4 level group （n=113） and low FT4 level group （n=19）. There were statistically significant difference of SDS scores (P<0.05) in 3 groups, but no significant difference in the occurrence of depression (P>0.05). In Pearson correlation analysis, SDS score was positively correlated with serum FT3 ( r=0.372, P<0.001) and FT4 level ( r=0.288, P<0.001), negatively correlated to serum TSH level but no statistically significant ( r=-0.028, P=0.614). logistic regression analysis showed that TSH （P=0.131）, FT4 （P=0.637）, and FT3 (P=0.208) were not the independent risk factors for the occurrence of depression. Conclusion Although the prevalence of depression is high in Graves disease patients, there is no close correlation between depression and the level of thyroid hormone.