抑郁症患者抗抑郁药治疗效果与述情障碍及甲状腺功能的关系

目的:探讨抑郁症患者抗抑郁药治疗的效果与述情障碍及甲状腺功能的关系。方法:52例抑郁症患者经抗抑郁治疗8周后给予汉密尔顿抑郁量表(HAMD-17)评定,≤7分为治愈组(28例),7分为非治愈组(24例);于治疗前检测三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)水平;采用多伦多述情障碍量表(TAS-20)于治疗前后评估述情障碍程度,对述情障碍与甲状腺激素水平的相关性进行分析。结果:治疗前治愈组TAS总分、F1、F2因子分低于非治愈组(Z=-2.493,t=-2.99,Z=-2.530;P0.05或P0.01);T3、T4水平高于非治愈组(Z=-2.801,Z=-2.294;P0.05或P0.01)。相关分析显示,治疗前TAS总分、F1因子分与T3、T4呈负相关(r=-0.291~-0.399;P0.05或P0.01)。结论:抑郁症患者的述情障碍越重则甲状腺激素水平越低,抗抑郁药疗效越差;反之亦然。

RelationshiP of effect of anti-dePressive drug for dePressive Patients with alexithymia and thyroid hor-mones

Objective:To explore the relationship of effect of anti-depressive drug for depressive patients with alexithymia and thyroid hormones. Method:Fifty-two depressive patients were evaluated by Hamilton de-pression scale(HAMD-17)after eight weeks′ therapy,and divided into cured group(HAMD-17≤7)(28 ca-ses)and non-cured group(HAMD-17 > 7)(24 cases)in terms of HAMD score. Levels of triiodothyronine (T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine(FT4)and hormothyrin(TSH)were meas-ured before treatment. Toronto alexithymia scale(TAS-20)was adminstered before and after treatment. Correla-tion between alexithymia and thyroid hormones was conducted. Results:Before treatment,TAS total score,F1 factor score,F2 factor score of cured group were lower than those of non-cured group(Z = - 2. 493,t = - 2. 99, Z = - 2. 530);P < 0. 05 or P < 0. 01),while the levels of T3 and T4 of cured group were higher than non-cured group(Z = - 2. 801,Z = - 2. 294;P < 0. 05 or P < 0. 01). TAS total score,F1 factor had negative correlation with T3 and T4(r = - 0. 291- - 0. 399;P < 0. 05 or P < 0. 01). Conclusion:The higher alexithymia may cause lower thyroid hormones and worse effect of depression treatment,and the converse is also true.