氟西汀治疗甲状腺功能亢进伴情感障碍患者的临床观察

Clinical observation of fluoxetine in affective disorder of patients with hyperthyroidism

目的 探讨氟西汀对甲状腺功能亢进患者情感障碍的疗效。方法 将 5 0例符合《中国精神障碍分类与诊断标准》第3版 (CCMD 3)抑郁症诊断标准的甲状腺功能亢进患者随机分为研究组 2 5例 ,在应用治疗甲状腺功能亢进药物的基础上联合抗抑郁剂氟西汀 2 0mg·d-1;对照组 2 5例 ,仅应用治疗甲状腺功能亢进药物治疗。疗程 8w。采用SDS ,SAS评定疗前及治疗4、8w末抑郁焦虑症状减分率 ,并于治疗前及治疗 8w末测定TT3 、TT4含量评定甲状腺功能亢进疗效 ,全部数据采用t检验。结果 经 8w治疗 ,研究组各期SDS、SAS评分及TT3、TT4值较对照组下降明显 ,差异有显著性 (P <0 .0 5～ 0 .0 1) ;两组疗前与疗后 8w末SDS、SAS、TT3、TT4比较 ,差异有极显著性 (P <0 .0 1)。结论 氟西汀不仅能改善甲状腺功能亢进患者的抑郁、焦虑情绪 。

Objective To explore curative effect of fluoxetine in affective disorder of patients with hyperthyroidism. Methods 50 patients with hyperthyroidism(met the criterion for depression from the CCMD-3) were randomly divided into research group(n=25,anti- hyperthyroidism combined with fluoxetine 20mg/d) and control group(n=25,single anti- hyperthyroidism) for 8 weeks. Score-decrease rates of depressive and anxious symptoms at pre-treatment and ends of the 4th and 8th week of treatment were evaluated by the SDS and SAS, and levels of TT 3 and TT 4 measured at pre-treatment and end of the 8th week to evaluate the curative effect of hyperthyroidism. Statistic treatments of all data were conducted with t-test. Results After 8-week treatment, compared with control group ,scores of SDS,SAS and values of TT 3 ,TT 4 in research group obviously decreased,differences were significant(P<0.05～0.01) ;differences were the most significant in comparisons of the SDS,SAS, TT 3 and TT 4 of both the 2 groups between pre-treatment and end of 8th week(P<0.01). Conclusion Fluoxetine could improve depressive and anxious emotions and prompt protopathy's recovery for patients with hyperthyroidism.[