难治性抑郁症患者甲状腺激素和血清超敏C反应蛋白与临床症状相关性探讨

A related study of thyroid hormone,serum hypersensitive C-reactive protein and clinical symptoms in patients with treatment-resistant depression

目的比较难治性抑郁症患者甲状腺激素和血清超敏C反应蛋白(Hs-CRP)与临床症状的相关性。方法选择103例难治性抑郁症患者(TRD组)、103例非难治性抑郁症患者(NTRD组)和103名健康人群(对照组),应用汉密尔顿抑郁量表(HAMD-17)评定抑郁症状,测量所有样本的甲状腺激素和Hs-CRP水平。结果 TRD组HAMD总分、焦虑/躯体化、睡眠因子分高于NTRD组(P<0.05)。TRD组和NTRD组T3、T4、FT3、FT4水平均低于对照组(P<0.05),HsCRP水平均高于对照组(P<0.05)。TRD组的FT3水平低于NTRD组患者(P<0.05),Hs-CRP水平高于NTRD组(P<0.05)。TRD组HAMD因子分与T4、FT3、FT4水平呈负相关(P<0.05),与Hs-CRP水平呈正相关(P<0.05)。Logistic回归分析结果显示,出现TRD的因素包括FT3水平降低、Hs-CRP水平升高。结论 TRD患者抑郁症状明显,其与甲状腺素和Hs-CRP水平有关。

Objective To explore the relationship of thyroid hormone,serum hypersensitive C-reactive protein（ Hs-CRP）and clinical symptoms in patients with treatment-resistant depression. Methods A total of 103 patients with treatment-resistant depression in TRD group,103 patients with depression in NTRD group and 103 healthy people in control group were selected,assessed with Hamilton Depression Scale（ HAMD） and examined with levels of thyroid hormone and Hs-CRP. Results The total score and factor scores of anxiety/somatization,sleep of HAMD in TRD group were all significantly higher than those in NTRD group（ P〈0. 05）. The levels of T3,T4,FT3 and FT4 in TRD group and NTRD group were all significantly lower than those in control group（ P〈0. 05） and the levels of Hs-CRP in TRD group and NTRD group were all significantly higher than that in control group（ P〈0. 05）. In TRD group,the level of FT3 was significantly lower than that in NTRD group（ P〈0. 05） and the level of Hs-CRP was significantly higher than that in NTRD group（ P〈0. 05）. In TRD group,part of the factor scores of HAMD were negatively correlated with the levels of T4,FT3,FT4（ P〈0. 05） and positively correlated with the level of Hs-CRP（ P〈0. 05）. Logistic regression analysis showed that the risk factors of TRD included the low level of FT3 and high level of Hs-CRP.Conclusion There are severe clinical symptoms in patients with TRD,which is correlated with the levels of thyroid hormone and Hs-CRP.