心境障碍首次躁狂发作患者血清甲状腺激素水平的研究

Changes and its significance of serum thyroid hormone levels in mood disorder patients with the first manic episode

目的:探讨心境障碍首次躁狂发作患者血清甲状腺激素水平的变化。方法:对90例心境障碍首次躁狂发作患者(研究组)分别于治疗前和治疗4周进行躁狂量表(BRMS)评估,同时测定血清甲状腺素(TT4)、三碘甲状腺原氨酸(TT3)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)水平,并与30名正常对照组比较;分析治疗前、后BRMS评分及其变化值与甲状腺激素水平变化值的相关性。结果:研究组治疗前血清FT4高于正常对照(t=3.633,P=0.000);TT3、TSH低于正常对照(t=-4.225,-4.082;P均=0.000);治疗后血清TT4、TT3、FT3、FT4较正常对照下降,TSH升高(t=-8.450,-10.581,-3.840,-3.170,2.662;P<0.01或P<0.001)。治疗前、后BRMS评分分别与TT3、FT3变化值呈正相关(P均<0.01);BRMS评分变化值与TT4、TT3、FT3及FT4变化值呈正相关(P<0.01或P<0.05);与TSH变化值呈负相关(P<0.01)。结论:心境障碍首次躁狂发作患者血清甲状腺激素水平发生变化,其中TT3、FT3变化幅度与情感症状的严重程度相关。

Objective：To explore the changes of serum thyroid hormone levels in mood disorder patients with the first manic episode. Method：Ninety inpatients with the first manic episode （ study group） were evaluated with Bech-Rafaelsen mania rating scale（ BRMS） and the serum thyroxine（ TT4 ） ,three iodine thyronine （ TT3 ） ,free triiodothyronine（ FT3 ） ,free thyroxine（ FT4 ） ,thyroid-stimulating hormone （ TSH） levels were detected before and 4 weeks after therapy. The results were compared with normal control group（ n = 30） . The correlation of the scores of BRMS before or after therapy and it＇s change value with the change value of serum thyroid hormone level were analyzed. Results：Compared with normal control group,the serum FT4 level in study group before therapy was higher （ t = 3. 633,P = 0. 000 ） ,TT3 ,TSH were lower than the control group（ t = - 4. 225,- 4. 082; all P = 0. 000） . The serum TT4 ,TT3 ,FT3 ,FT4 levels in study after therapy were decreased, the serum TSH level was increased （ t = - 8. 450,- 10. 581,- 3. 840,- 3. 170,2. 662; P 0. 01 or P 0. 001） . BRMS scores of before or after therapy were positive correlated with the change values of TT3 ,FT3 （ all P 0. 01） . The change value of BRMS scores was positive correlated with the change values of TT3 ,TT4 ,FT3 , FT4 （ P 0. 01 or P 0. 05） ; negative with the change value of TSH（ P 0. 01） . Conclusion：The serum thyroid hormone levels are changed in patients with manic episode,the change values of serum TT3、FT3 levels are correlated with the severity of emotion symptoms.