双相情感障碍患者临床特征与甲状腺功能水平相关性分析
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摘要
探讨双相情感障碍患者临床特征与甲状腺功能水平的相关性。方法选取中山市第三人民医院2016年5月—2017年10月住院的92例双相情感障碍患者为研究对象,其中躁狂患者62例,抑郁患者30例。入院第二天早晨7:30抽取空腹血检测甲状腺功能水平,分析甲状腺功能水平的差异。对所有数据进行统计学处理。结果双相情感障碍躁狂组与抑郁组患者的甲状腺功能水平TSH、TT3、TT4、FT3、FT4比较,躁狂组的TT3、TT4、FT3、FT4高于抑郁组,TSH低于抑郁组,但差异均无统计学意义(P> 0. 05)。双相情感障碍躁狂组患者男性的TT4低于女性组,且差异具有统计学意义(P <0. 05);而双相情感障碍躁狂患者和抑郁患者的其它甲状腺功能与性别无关,即差异无统计学意义(P> 0. 05)。结论双相情感障碍患者的甲状腺功能水平可能存在异常,但改变不同。
Objective To investigate the relationship between clinical features and thyroid function in patients with bipolar disorder. Methods 92 patients with bipolar disorder who were hospitalized in the third people's Hospital of Zhongshan from May 2016 to October 2017 were selected. Among them,62 were manic patients and 30 were depressive patients.The level of thyroid function was measured at 7: 30 in the morning,and then the difference of thyroid function was analyzed.Finally,all the data were statistically processed. Results Compared with the depression group,the levels of TSH,TT3,TT4,FT3 and FT4 in the patients with bipolar disorder and mania group were higher than those in the depression group,while the TSH level was lower in the manic group than in the depression group,but the difference was not statistically significant( P > 0. 05). The TT4 in male patients with bipolar disorder was lower than that in the female group,and the difference was statistically significant( P < 0. 05). The other thyroid functions in bipolar disorder patients with mania and depression were not related to gender,i. e.,the difference was not statistically significant( P > 0. 05).Conclusion There may be abnormal thyroid function in patients with bipolar disorder,but the changes are different.
Objective To investigate the relationship between clinical features and thyroid function in patients with bipolar disorder. Methods 92 patients with bipolar disorder who were hospitalized in the third people's Hospital of Zhongshan from May 2016 to October 2017 were selected. Among them,62 were manic patients and 30 were depressive patients.The level of thyroid function was measured at 7: 30 in the morning,and then the difference of thyroid function was analyzed.Finally,all the data were statistically processed. Results Compared with the depression group,the levels of TSH,TT3,TT4,FT3 and FT4 in the patients with bipolar disorder and mania group were higher than those in the depression group,while the TSH level was lower in the manic group than in the depression group,but the difference was not statistically significant( P > 0. 05). The TT4 in male patients with bipolar disorder was lower than that in the female group,and the difference was statistically significant( P < 0. 05). The other thyroid functions in bipolar disorder patients with mania and depression were not related to gender,i. e.,the difference was not statistically significant( P > 0. 05).Conclusion There may be abnormal thyroid function in patients with bipolar disorder,but the changes are different.
引文
[1]BAUER M,GOETZ T,GLENN T,et al.The thyroid-brain interaction in thyroid disorders and mood disorders[J].J Neuroendocrinol,2008,20(10):1101-1114.
[2]CHANG KD,KECK PE JR,STANTON SP,et al.Differences in thyroid function between bipolar manicand mixed states[J].Biol Psychiatry,1998,43(10):730-733.
[3]ZARATE CA,TOHEN M,ZARATE SB.Thyroid function tests in firstepisode disorder manic and mixed types[J].Biol Psychiatry,1997,42(4):302-304.
[4]王筱兰,侯钢,朱荣鑫,等.双相情感障碍神经内分泌功能对照研究[J].临床精神医学杂志,2009,19(6):379-381.
[5]粟幼嵩,陈俊,洪武,等.以抑郁或躁狂首次发病的双相障碍患者临床特征及甲状腺功能水平回顾性分析[J].中华精神科杂志,2016,49(1):42-46.
[6]王小泉,王祖森,侯正华,等.单、双相抑郁症临床特征及血清甲状腺激素水平比较[J].精神医学杂志,2015,28(3):182-185.
[7]EVANS DL,STRAWN SK,HAGGERTY JJJR.Appearance of mania in drug-resistant bipolar depressed patients after treatment with L-triiodothyronine[J].J Clin Psychiatry,1986,47(10):521-522.
[8]BEI ES,SALPEAS V,ALEVIZOS B,et al.Pattern of heat shock factor and heat shock protein expression in lymphocytes of bipolar patients:increased HSP70-glucocorticoid receptor heterocomplex[J].J Psychiatr Res,2013,47(11):1725-1736.
[9]靳佳佳,冉柳毅,王我,等.双相情感障碍患者甲状腺功能水平的分析[J].重庆医科大学学报,2017,42(5):574-578.
[10]石磊.甲状腺功能水平与双相情感障碍相关性比较分析[J].中西医结合心血管病杂志,2017,4(5):13-14.
[2]CHANG KD,KECK PE JR,STANTON SP,et al.Differences in thyroid function between bipolar manicand mixed states[J].Biol Psychiatry,1998,43(10):730-733.
[3]ZARATE CA,TOHEN M,ZARATE SB.Thyroid function tests in firstepisode disorder manic and mixed types[J].Biol Psychiatry,1997,42(4):302-304.
[4]王筱兰,侯钢,朱荣鑫,等.双相情感障碍神经内分泌功能对照研究[J].临床精神医学杂志,2009,19(6):379-381.
[5]粟幼嵩,陈俊,洪武,等.以抑郁或躁狂首次发病的双相障碍患者临床特征及甲状腺功能水平回顾性分析[J].中华精神科杂志,2016,49(1):42-46.
[6]王小泉,王祖森,侯正华,等.单、双相抑郁症临床特征及血清甲状腺激素水平比较[J].精神医学杂志,2015,28(3):182-185.
[7]EVANS DL,STRAWN SK,HAGGERTY JJJR.Appearance of mania in drug-resistant bipolar depressed patients after treatment with L-triiodothyronine[J].J Clin Psychiatry,1986,47(10):521-522.
[8]BEI ES,SALPEAS V,ALEVIZOS B,et al.Pattern of heat shock factor and heat shock protein expression in lymphocytes of bipolar patients:increased HSP70-glucocorticoid receptor heterocomplex[J].J Psychiatr Res,2013,47(11):1725-1736.
[9]靳佳佳,冉柳毅,王我,等.双相情感障碍患者甲状腺功能水平的分析[J].重庆医科大学学报,2017,42(5):574-578.
[10]石磊.甲状腺功能水平与双相情感障碍相关性比较分析[J].中西医结合心血管病杂志,2017,4(5):13-14.