脑卒中急性期抑郁患者甲状腺功能变化的临床研究

Clinical study on the changes of thyroid function in patients with poststroke depression

目的 探讨脑卒中急性期抑郁患者甲状腺功能的变化。方法 对 10 9例急性脑卒中患者进行分组 (卒中后无抑郁组 6 6例和卒中后抑郁组 4 3例 )。收集两组发病第 2天及第 14天两次空腹血清 ,采用化学发光法进行甲状腺功能测定 ,并与 4 0例正常健康体检者 (对照组 )进行比较。结果 第 2天甲状腺功能变化情况 :卒中后抑郁组和卒中后无抑郁组比对照组血清游离三碘甲状腺原氨酸 (FT3)水平明显下降 ,而血清游离甲状腺素 (FT4 )水平显著增高 ,卒中后抑郁组比卒中后无抑郁组的变化程度更显著 ;卒中后无抑郁组血清促甲状腺素 (TSH)水平比对照组显著增高 ,但卒中后抑郁组TSH水平升高不明显。第 14天甲状腺功能变化情况 :卒中后无抑郁组FT3、FT4 、TSH均恢复接近正常 ,与对照组比较无差异 ;卒中后抑郁组FT3、FT4 虽有恢复但不明显 ,与对照组比较有显著差异 ;3组的TSH水平比较均无差异。结论 脑卒中患者甲状腺功能发生变化 ,而卒中后抑郁患者比无抑郁患者FT3、FT4 变化更明显 ,且恢复慢。

Objective To study the changes in the thyroid function of the patients with depression after acute stroke.Methods 109 patients suffering from stroke were divided into two groups: The first group was composed of patients without depression (n=66) and the second group with depression(n=43 ). Thyroid function (FT 3,FT 4,TSH) was tested by chemoluminescence method on second day and 14th day respectively after stroke and compared with normal control group.Results The changes of thyroid function on second day: FT 3 was significantly decreased but FT 4 was obviously elevated in the two groups as compared with the control and the changes were more obvious in the second group than in the first group; TSH was greatly increased in the first group as compared with the control, whereas it had no significant difference from the control in the second group.The changes of thyroid function on the 14th day:the levels of FT 3,FT 4 and TSH were almost within the normal ranges in the first group and had no difference from the control; but FT 3 and FT 4 were still abnormal in the second group as compared with the control.TSH was not significantly different between the three groups.Conclusion The thyroid function changes after stroke and the changes of FT 3 and FT 4 are more significant in the patients with post stroke depression than those without depression and recover slowly.