首发单相抑郁症与双相抑郁症患者外周血甲状腺激素水平比较

Comparison of peripheral blood thyroid hormone levels in patients with first-episode unipolar depression and bipolar depression

目的探讨首发单相抑郁症与双相抑郁症患者外周血甲状腺激素(TH)水平的差异,以及TH水平与汉密尔顿抑郁量表24项版(HAMD-24)、汉密尔顿焦虑量表(HAMA)评分的相关性。方法选取2018年11月至2020年10月在浙江省人民医院精神卫生科住院的首发抑郁症患者92例,其中单相抑郁症47例,双相抑郁症45例;同期在医院进行健康体检的健康对照者94例。比较3组对象外周血TH水平,分别分析单相抑郁症、双相抑郁症患者外周血TH水平与HAMD-24、HAMA评分的相关性。结果3组对象外周血促甲状腺激素(TSH)、T3、T4、FT3水平比较,差异均有统计学意义(均P<0.05),而FT4水平比较差异无统计学意义(P>0.05);其中单相抑郁组、双相抑郁组患者外周血TSH、T3、T4、FT3水平均低于健康对照组(均P<0.05),双相抑郁组外周血T3水平高于单相抑郁组(P<0.05)。单相抑郁症患者外周血TSH水平与HAMD-24体重因子评分呈负相关(r=-0.308,P<0.05),FT4水平与HAMD-24日夜变化因子评分呈负相关(r=-0.380,P<0.05)。双相抑郁症患者外周血T4水平与HAMD-24焦虑/躯体化因子评分、HAMA总分均呈正相关(r=0.366、0.356,均P<0.05),FT4水平与HAMA总分呈正相关(r=0.319,P<0.05)。结论首发单相抑郁症、双相抑郁症患者外周血TH水平较健康对照者明显降低,而单相抑郁症与双相抑郁症患者仅T3水平存在差异;外周血TSH、FT4、T4等指标与HAMD-24、HAMA具有一定的相关性。

Objective To investigate the peripheral blood thyroid hormone(TH)levels in patients with first-episode unipolar depression and bipolar depression,and the correlation between TH level and the score of Hamilton depression scale-24(HAMD-24)and Hamilton anxiety scale(HAMA).Methods Ninety-two first-episode depressive patients admitted to the Department of Psychiatry of Zhejiang Provincial People’s Hospital from November 2018 to October 2020 were recruited,including 47 cases of unipolar depression and 45 cases of bipolar depression,and 94 healthy subjects served as controls.The perip heral blood TH levels were measured in three groups,and the correlation of TH levels with HAMD-24 and HAMA scores was analyzed in unipolar depression and bipola r depression patients.Results The levels of TSH,T3,T4 and FT3 in peripheral blo od in unip olar depression and bipolar depression groups were significantly lower than those of normal control group(P<0.05),and the level of T3 in bipolar depression group was higher than that in unipolar depression group(P<0.05).In unip olar depression patients the TSH level was negatively correlated with HAMD-24 weight fa ctor score(r=-0.308,P<0.05),the FT4 level was negatively correlated with HAMD-24 day and night change factor score(r=-0.380,P<0.05).In bip olar depression patients the T4 level was positively correlated with HAMD-24 anxiety/somatization factor score and overall score of HAMA(r=0.366,0.356,P<0.05),and T4 level was po s itively correlated with the overall score of HAMA(r=0.319,P<0.05).Conclusion The TH levels in peripheral blood of patients with first episode unipolar depression and bipolar depression are signiificantly lower than those in normal controls,while only T3 level shows a difference between unipolar and bipolar depression patients.The TSH,FT4 and T4 levels are correlated with HAMD-24 and HAMA to some extent in depressive patients.