甲状腺功能水平与抑郁症的相关性探索

目的探索甲状腺功能与抑郁症之间的相关性。方法应用酶联免疫吸附法法测定38例抑郁症患者和性别匹配的38名正常对照的总三碘甲腺原氨酸（TT3）,总甲状腺素（TT4）,促甲状腺激素（TSH）的水平,汉密尔顿抑郁量表（HAMD-17）项评定抑郁的严重程度,汉密尔顿焦虑量表（HAMA）评定患者的焦虑严重程度,社会功能大体评定量表（GAF）评估患者的社会功能状况。结果抑郁症患者的平均TT3水平为（1.03±0.58）ng/mL,平均TT4水平为（8.20±2.53）ug/dL,平均TSH水平为（2.75±1.77）uIU/mL,健康对照组的平均TT3水平为（0.69±0.30）ng/mL,平均TT4水平为（7.10±1.25）ug/dL,平均TSH水平为（3.44±2.20）uIU/mL,两组间TT3,TT4水平具有统计学差异,TSH的组间差异未达到统计学显著水平。女性抑郁症患者的平均TT3水平为（1.14±0.69）ng/mL,平均TT4水平为（9.00±2.94）ug/dL,健康对照组的平均TT3水平为（0.60±0.21）ng/mL,平均TT4水平为（6.92±0.88）ug/dL,组间TT3、TT4水平具有统计学差异。男性抑郁症组,TSH水平与躯体性焦虑呈正相关（r=0.582,P=0.014）,与GAF总分呈负相关（r=-0.555,P=0.021）。结论抑郁症患者甲状腺功能存在一定变化,这种变化以女性患者明显,甲状腺激素水平与抑郁症患者的一些症状存在相关性。

Association between thyroid function and major depression

Objective：To explore the association between thyroid function and major depression.Methods： The serum total triiodothyronine（TT3）,total thyroxine（TT4）,thyroid stimulating hormone（TSH） levels were measured using enzyme-linked immunosorbent assay in 38 patients with major depression and 38 healthy controls.Gender was matched between the two groups.Hamilton depression scale-17（HAMD-17） was used to assess the severity of depression.The severity of anxiety was assessed using Hamilton anxiety scale（HAMA）.Social function of the patients was assessed using global assessment function（GAF）.Results：In depression patients,the average serum level was（1.03±0.58）ng/mL for TT3,（8.20±2.53）ug/dL for TT4 and（2.75±1.77）uIU/mL for TSH.In healthy controls,the average serum level was（0.69±0.30） ng/mL for TT3,（7.10±1.25）ug/dL for TT4 and（3.44±2.20） uIU/mL for TSH.There were significant differences in both TT3 and TT4 between the two groups while there was no significant difference in TSH between the two groups.In female depression patients,the average serum level was（1.14±0.69） ng/mL for TT3 and（9.00±2.94） ug/dL for TT4.In female healthy controls,the average serum level was（0.69±0.21） ng/mL for TT3 and（6.92±0.88）ug/dL for TT4.There were significant differences in both TT3 and TT4 between the two groups.In male depression patients,the serum TSH level was positively correlated to somatic symptoms of anxiousness（r=0.582,P=0.014） and negatively correlated to GAF scores（r=-0.555,P=0.021）.Conclusion：Thyroid function change was found in some depression patients,especially in female.Thyroid hormones were significantly correlated to certain clinical symptoms and features of depression.