抑郁症患者甲状腺素水平紊乱与生物节律之间的关系

目的 探讨抑郁症患者甲状腺激素水平紊乱和生物节律紊乱之间的关系，为患者的治疗提供参考依据。方法 连续纳入2020年6月至2022年3月在安徽省精神卫生中心就诊的抑郁症患者90例，同期纳入90例健康对照人群。比较两组对象神经精神生物节律评定晤谈（BRIAN）评定得分、血清甲状腺激素水平的差异，并分析BRIAN评分与甲状腺激素水平的相关性。结果 与对照组相比，抑郁症患者BRIAN总分、睡眠、活动、社交、进食、夜间活动、昼夜节律颠倒评分增高（P<0.05），早晨活动评分降低（P<0.05）。抑郁症组促甲状腺激素（TSH）水平升高，四碘甲状腺氨酸（TT4）、游离四碘甲状腺氨酸（FT4）、游离三碘甲状腺氨酸（FT3）水平降低（P<0.05）。相关性分析提示，TSH水平与BRIAN总分呈正相关，TT4及FT4水平与BRIAN总分呈负相关，而TT3及FT3与BRIAN评分无相关性。线性回归分析提示，TSH水平升高、FT4水平降低是影响抑郁症患者生物节律紊乱的危险因素。结论 抑郁症患者生物节律紊乱与甲状腺功能密切相关。

Relationship between disturbed thyroxin levels and biorhythms in patients with depression

Objective The aim of this study was to investigate the correlation between biorhythm disturbances and serum thyroid hormones level in patients with depression. Methods Ninety patients with depression who were hospitalized at Anhui Mental Health Centre from June 2020 to March 2022 were consecutively included, and 90 healthy controls were included during the same period. The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to assess biological rhythms. Results Compared with controls, patients with depression had significantly higher BRIAN total score, sleep domain, activity domain, social domain, eating domain, nocturnal activity, and circadian rhythm reversal scores (P<0.05) and significantly lower morning activity scores (P<0.05). Serum thyrotropin (TSH) levels were significantly higher and total thyroxine (TT4), free thyroxine (FT4) and free triiodothyronine (FT3) levels were significantly lower in the depression group. Correlation analysis suggested that TSH levels were positively correlated with BRIAN total scores, TT4 and FT4 levels were negatively correlated with BRIAN total scores, while TT3 and FT3 were not correlated with BRIAN scores. Linear regression analysis suggested that elevated TSH levels and reduced FT4 levels were risk factors for biorhythm disturbances in depressed patients. Conclusions Biorhythm disturbances in depressed patients are closely related to serum thyroid hormone level.