双相情感障碍神经内分泌功能对照研究

A Controlled study of neuroendocrine functions of bipolar affective disorder

目的:探讨双相情感障碍混合发作与躁狂发作患者神经内分泌功能。方法:以放射免疫方法测定23例双相情感障碍混合发作患者(混合组)、54例躁狂发作患者(躁狂组)和38名正常人(对照组)血浆皮质醇(Cor)、促肾上腺皮质激素(ACTH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)及促甲状腺激素(TSH)的浓度。结果:混合组血浆Cor及ACTH浓度均明显高于对照组(P<0.05或P<0.001);而躁狂组与对照组血浆Cor浓度比较差异无统计学意义,但ACTH浓度明显高于对照组(P<0.001);混合组血浆Cor浓度明显高于躁狂组(P<0.05),但ACTH浓度两组间差异无统计学意义。与对照组相比,混合组T3浓度显著较高,T4浓度显著较低(P<0.05),而TSH浓度两组间差异无统计学意义(P>0.05);躁狂组T3浓度显著高于对照组(P<0.001),TSH浓度显著低于对照组(P<0.01);混合组T3、T4浓度均显著低于躁狂组(P<0.05或P<0.01),TSH浓度明显高于躁狂组(P<0.05)。结论:双相情感障碍混合发作及躁狂发作均存在神经内分泌功能的改变,但二者的改变并不相同。

Objective： To investigate the difference of neuroendocrine function between patients of bipolar affective disorder with mixed and manic episodes. Method ： The plasma cortisol （Cor） , adrenocorticotropic hormone （ ACTH ） , triiodothyro （ T3 ） , thyroxine （ T4 ） , thyroid stimulating hormone （TSH） levels were measured in 23 patients with mixed episode of bipolar affective disorder （ mixed group） ,54 patients with manic episode （manic group） and 38 normal controls （control group） by radioimmunoassay. Results：The plasma cortisol and ACTH levels were significantly higher in the mixed group than in the normal control group（ P 〈 0.05 or P 〈0.001 ） ,while there was no significant difference of the Cor level between the manic group and the control group, but the manic group showed higher ACTH level significantly than （ P 〈 0.05 ） and no significant difference on the plasma cortisol level from the normal control group. The mixed group did not display significant difference on ACTH but on cortisol from the manic group. The plasma T3 level was significantly higher and the T4 level was significantly lower in the mixed group than in the normal control group（ P 〈 0.05 ） ,while there was no significant difference of the TSH level between the two groups（ P 〉 0.05 ）. The plasma T3 level was significantly higher and the TSH level was significantly lower in the mixed group than in the normal control group（ P 〈 0.01 ）. The plasma T3 and T4 levels were significantly lower in the mixed group than in the manic group（ P 〈0.05 or P 〈 0.01 ） and the TSH level was significantly higher in the mixed group （ P 〈 0.05 ）. Conclusion： Change of neuroendoerine function exists both in bipolar mixed episode and manic episode, but the change may be different.