精神分裂症患者血清甲状腺激素水平变化的临床意义

目的探讨精神分裂症患者血清甲状腺相关激素水平变化的临床意义。 方法采用化学发光免疫法检测145例精神分裂症患者(研究组)三碘甲状腺原氨酸(T₃)、甲状腺素(T₄)，及促甲状腺激素(TSH)水平，并与30例正常健康人(对照组)进行比较。采用SPSS 18.0软件包进行数据处理，对研究组年龄、病程、性别、阳性与阴性症状量表(PANSS)评分、阴性症状分、阳性症状分、一般精神病理分进行Person相关分析。 结果研究组血清甲状腺激素T₃、T₄、TSH水平治疗前(1.27±0.37)nom/L、(97.29±19.69)nmol/L、(1.82±1.11)mU/L]与对照组(1.93±0.28)nom/L、(113.51±18.92)nmol/L、(2.59±1.10)mU/L]比较，差异有统计学意义(t＝12.89，5.50，4.57；均P<0.05)；研究组血清甲状腺激素水平在不同病程组与对照组比较T₃偏低(T₃：t＝7.16，9.01，8.90，8.90，8.47；均P<0.05)；T₄在病程2年以上研究组与对照组比较差异有统计学意义(t＝2.86，3.93，4.27，4.10；均P<0.05)，TSH病程在2年以下的研究组与对照组比较差异有统计学意义(t＝3.42，4.02，均P<0.05)；在不同年龄的研究组与对照组比较发现研究组血清T₃、T₄偏低(T₃在≥20岁病例组中：t＝7.93，8.86，9.71，7.76，9.01；均P<0.05；T₄在<50岁研究组中：t＝3.70，4.28，5.04，3.77；均P<0.05)；TSH在≥50岁研究组中t＝2.91，P<0.05)。T₃水平与PANSS中精神病理分呈现正相关(r＝0.176，P<0.05)；T₄水平与病程成负相关(r＝－0.188，P<0.05)；TSH水平与PANSS中精神病理分呈现正相关(r＝0.199，P<0.05)，与PANSS中阴性症状分呈现负相关(r＝－0.202，P<0.05)。 结论精神分裂症患者存在下丘脑-垂体-甲状腺调节紊乱，与病程、精神病理分、阴性症状相关。

Clinical significance of serum thyroid hormone levels in schizophrenic patients

ObjectiveTo investigate the clinical significance of serum thyrorid hormone levels in schizophrenic patients.. MethodsThe three triiodothyronine (T₃), thyroxine (T₄), and thyroid stimulating hormone (TSH) level were monitoring by chemilumincence immune in one hundred and forty-five patients with schizophrenia, and thirty cases of normal healthy people (control group) were considered as control.Studies on the age, course, gender, positive and negative symptoms scale, negative symptoms, positive symptoms, general psychopathology scale were analyzed by Person correlation analysis. ResultsSerum thyroid hormone levels were studied before treatment(1.27±0.37)nom/L、(97.29±19.69)nmol/L、(1.82±1.11)mU/L] and in control group(1.93±0.28)nom/L、(113.51±18.92)nmol/L、(2.59±1.10)mU/L], the difference was statistically significant (t=12.89, 5.50, 4.57; P<0.05) .The level of serum thyroid hormone was lower in T₃ compared different course of the study group and the control group (T₃: t=7.16, 9.01, 8.91, 8.90, 8.47; P<0.05) in the course of two years of the study group and the control group, the difference was statistically significant (t=2.86, 3.93, 4.27, 4.10; P<0.05), the course of TSH in the study group and the control group 2 years in a statistically significant difference(t=3.42, 4.02; P<0.05); in the study group and the control group comparison study of different ages.The level of serum T₃, T₄ (T₃≥20 was lower in case group: t=7.93, 8.86, 9.71, 7.76, 9.01; P<0.05; T₄ in<50 years old group: t=3.70, 4.28, 5.04, 3.77; P<0.05); TSH≥50 years study in group t=2.91, P<0.05). Psychiatric T₃ level and PANSS in positive correlation (r=0.176, P<0.05); T₄ level and duration of negative correlation (r=-0.188, P<0.05); mental pathology in TSH level and PANSS in positive correlation(r=0.199, P<0.05), and PANSS negative scores showed a negative correlation (r=-0.202, P<0.05). ConclusionSchizophrenic patients have the hypothalamus-pituitary-thyroid adjustment disorder which associated with the course of disease, mental pathology, negative symptoms.