雙相抑郁障礙與單相抑郁癥患者促甲狀腺激素的相關性研究

陳倩倩+湯義平+齊文耀

[摘要] 目的 探討雙相抑郁障礙與單相抑郁癥患者的促甲狀腺激素的相關性。方法 選取我院2015年1月～2016年6月收治的抑郁癥患者37例，按照患者病情不同分為單相組（19例）和雙相組（18例），選取同期進行體檢后的健康人群18例作為對照組，檢測三組患者的T3、T4、TSH等指標，并行HAMD量表評分。結果 治療前雙相組、單相組患者T3水平為（2.05±0.63）nmol/L、（2.01±0.36）nmol/L，高于對照組的（1.65±0.65）nmol/L，差異顯著（P<0.05）；雙、單相組患者的T4、TSH水平與對照組相比，無統計學意義（P>0.05）。治療后單相組和雙相組T4水平與對照組相比，差異顯著（P<0.05）。治療前兩組HAMD量表評分無明顯差異（P>0.05）；治療后單相組評分為（4.75±0.51）分，優于雙相組的（6.65±0.55）分，差異有統計學意義（P<0.05）。結論 大多數抑郁癥患者的甲狀腺激素水平存在異常，治療后單相抑郁障礙的患者臨床癥狀改善較雙相抑郁障礙明顯，激素水平得到改善，提示單相抑郁障礙的發生主要與其激素水平變化有密切關系，與雙相抑郁障礙關系尚不明確。

[關鍵詞] 雙相抑郁障礙；單相抑郁障礙；抑郁癥；促甲狀腺激素

[中圖分類號] R749.4 [文獻標識碼] B [文章編號] 1673-9701（2017）07-0088-04

[Abstract] Objective To investigate the correlation of thyrotropin between bipolar depression and monopolar depression. Methods 37 patients with depression who were admitted to our hospital from January 2015 to June 2016 were selected. According to different conditions， the patients were divided into monopolar group （19 cases） and bipolar group （18 cases）. 18 healthy people who were given physical examination during the same period were selected as the control group. T3， T4， TSH and other indices were tested in the three groups and the score of HAMD scale was calculated. Results The level of T3 in the bipolar group and the monopolar group before the treatment was（2.05±0.63） nmol/L and（2.01±0.36） nmol/L， which was higher than that in the control group （1.65±0.65） nmol/L， and the difference was significant（P<0.05）； there were no statistically significant difference in T4 and TSH levels between the bipolar and monopolar groups and the control group（P>0.05）. The T4 level in the the bipolar and monopolar groups was significantly different from that in the control group， and the difference was significant （P<0.05）. There was no significant difference in HAMD score between the two groups before treatment （P>0.05）； after the treatment， the score in the monopolar group was （4.75 ± 0.51） points， which was better than（6.65±0.55） in the bipolar group， and the difference was statistically significant（P<0.05）. Conclusion Most patients with depression have abnormal thyrotropin level. After the treatment， the improvement of clinical symptoms in the patients with monopolar depression are more significant the patients with bipolar depression， and the hormone level is improved， suggesting that the occurrence of monopolar depressive disorder is closely related to the changes in hormone levels， and its correlation with the bipolar depression is not yet clear.

[Key words] Bipolar depression； Monopolar depression； Depression； Thyrotropin

抑郁癥是臨床上常見重性精神疾病的重要類型，主要臨床表現為與處境不相符的、顯著持久的心境低落，并且伴有相應的行為及認知改變[1]。根據患者臨床癥狀中有無躁狂發作，將抑郁障礙分為雙相抑郁和單相抑郁[2]。臨床上甲狀腺的功能和抑郁癥有著一定關系[3]。有研究表明大多數的抑郁癥患者會存在甲狀腺功能減退的情況，這可能與下丘腦-垂體-甲狀腺軸亢進有關[4]。甲狀腺功能亢進的患者可能會出現躁狂、焦慮、驚恐等情緒障礙，若患者出現甲狀腺功能減退則會有自卑、無力、抑郁、記憶損害等癥狀[5]。為探討雙相抑郁障礙與單相抑郁癥患者的促甲狀腺激素的相關性，本文選取我院2015年1月～2016年6月收治的抑郁癥患者37例作為研究對象，按照患者病情不同分為單相組（19例）和雙相組（18例），并選取同期進行體檢后的健康人群18例對照組。……