改良电抽搐治疗对抑郁发作患者甲状腺功能和性激素的影响

目的 探讨抑郁发作患者接受改良电抽搐治疗(modified electroconvulsive therapy，MECT)后甲状腺功能和性激素的变化。 方法 选择符合ICD-10诊断标准的抑郁发作患者57例，采用化学发光免疫法分别检测MECT治疗后30 min和疗程结束后的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺功能(FT4)、促甲状腺功能(TSH)、三碘甲状腺原氨酸(T3)、甲状腺功能(T4)、睾酮(T)、雌二醇(E2)及血清泌乳素(PRL)。采用汉密尔顿抑郁量表17项版(Hamilton Depression Rating Scale，HAMD)对治疗前后的抑郁发作患者进行症状严重程度评定。分析甲状腺功能及性激素与HAMD评分的相关性。 结果 MECT治疗后30 min，甲状腺功能无明显变化(P＞0.05)，E2水平显著下降(P＜0.01)，PRL水平显著升高(P＜0.01)。MECT疗程结束后,T3、FT3和E2水平显著增高(P＜0.01)。MECT治疗前后T3水平与HAMD中阻滞因子负相关(r=-0.480,r=-0.471，P＜0.01)，T水平与HAMD中阻滞因子负相关(r=-0.412,r=-0.385，P＜0.01)，其他甲状腺功能和性激素与HAMD评分各因子分无相关。 结论 经MECT治疗的抑郁发作患者可以监测其甲状腺功能水平及性激素水平，以便于临床医生观察疗效和调整治疗方案。 

Effect of modified electroconvulsive therapy on thyroxine and sex-hormone of patients experiencing an episode of depression

Objective To explore the effect of modified electroconvulsive therapy(MECT) on thyroxine and sex-hormone of the of patients experiencing an episode of depression. Methods Fifty-seven patients meeting the criteria of ICD-10 for depression episode were enrolled into the study.The levels of serum free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),triiodothyronine(T3),thyroxine(T4),testosterone(T),estradiol(E2) and prolactin(PRL) were tested at 30-minutes after the treatment and the end of treatment.Hamilton Depression Rating Scale(HAMD) was performed before and after the treatment to assessseverity of symptom.The correlations among thyroxine,sex-hormone and scores of HAMD were analyzed. Results Thyroxine had no significant changes,E2 was significantly decreased 30-minutes after the treatment(P<0.01),while PRL was significantly increased after that(P<0.01).T3,FT3 and E2were significantly increased at the end of the treatment(P<0.01).There was significant negative correlation between level of T3 and scores of retardation factor before and after the treatment(r=-0.480,r=-0.471,P<0.01).There was significant negative correlation between level of T and scores of retardation factor before and after the treatment(r=-0.412,r=-0.385,P<0.01) while no correlation among other thyroxine,Sex-hormone and scores of HAMD. Conclusion The clinical doctors can evaluate the efficacy and adjust treatment plan based on the levels of thyroxine and sex-hormone in depressive episodes patients receiving MECT.