甲亢131碘治疗前患者心理健康状态与细胞因子变化的关系

Correlation Between Mental Health Status and Changes of Cytokines in Patients with Hyperthyroidism before Treatment with 131I

[目的] 探讨甲亢131碘治疗前患者的个性及心理健康状况与细胞因子白介素（IL-1、IL-6）和肿瘤坏死因子-α（TNF-α）的关系.[方法]对48例甲亢131碘治疗前患者和40例正常对照组,进行艾森克人格（EPQ）和心理健康状况（SCL-90）评定;用放射免疫分析法检测治疗前外周血IL-1、IL-6、TNF-α水平,对比分析人格和SCL-90各因子与血清IL-1、IL-6和TNF-α变化的相关性.[结果]甲亢131碘治疗前患者的精神度（P）和神经质（N）分值显著高于正常对照组（P〈0.05 、0.01）;甲亢患者多属于抑郁质人格,而对照组多属于多血质和粘液质人格特质;甲亢患者SCL-90症状因子分所有指标分值均显著高于对照组（P〈0.05、P〈0.01）.甲亢131碘治疗前患者血清IL-1水平与对照组无统计学意义（P＞0.05）;血清IL-6及TNF-α水平高于对照组（P〈0.05）.相关性分析显示：IL-1与性格及SCL-90呈负相关（r=-0.73、-0.53、-0.39、-0.86、-0.31、-0.97,P〈0.05、P〈0.01）;IL-6与性格及SCL-90呈负相关（r=-0.64、-0.54、-0.61、-0.45、-0.76、-0.31、-0.36、-0.66、-0.51,P〈0.05、P〈0.01）;TNF-α与性格及SCL-90呈正相关（r=0.43、0.82、0.29,P〈0.05、P〈0.01）.[结论] 甲亢患者具有内向不稳定型及神经质的人格特征,在情绪方面存在一定问题,总体心理健康状况较差;在甲亢发病中,血清IL-1、IL-6和TNF-α有明显变化,而且与患者个性特征和心理健康水平均有显著相关性.

[Objective] To explore the correlation between individuality, mental health status and cytokines interleukin-1 （IL-1）, interleukin-6（IL-6） and tumor necrosis factor-alpha（TNF-α） in patients with hyperthyroidism before treatment with ^131I. [Methods] Eysenck personality questionnaire（EPQ） and status of mental health（SCL-90） in 48 patients with hyperthy- roidism before treatment with ^311I and 40 healthy people were evaluated. Radioimmunoassay was used to determine the levels of IL-1, IL-6 and TNF-α in peripheral blood before treatment. The correlation between each factors of EPQ and SCL-90 and serum changes of IL-1, IL-6 and TNF-α were analyzed. [Results] The spirit（P） and neuroticism（N） scores in patients with hy- perthyroidism before treatment with 1311 were obviously higher than those in control group（ P 〈0.05, P 〈0.01）. Most of patients with hyperthyroidism were considered as depressed personality, while most of normal controls were regarded as sanguine and phlegmatic personality. The symptom factor scores of SCL-90 in patients with hyperthyroidism were significantly higher than those in control group（ P〈0.05, P 〈0.01）. There was no statistical significance in serum IL-1 level between patients with hyperthyroidism before treatment with ^131I and control group（ P 〉0.05）. Serum IL-6 and TNF-a levels in patients with hyperthyroidism before treatment with ^131I were higher than those in control group（ P 〈0.05）. Correlation analysis showed that IL-1 was negatively related with character and SCL-90（r=-0.73, --0.53, --0.39, --0.86, --0.31, --0.97, P 〈0.05, P 〈0.01）. IL-6 was negatively correlated with character and SCL-90 （r=- 0.64, --0.54, --0.61, --0.45, --0.76, --0.31, --0.36, --0.66, --0.51, P 〈0.05, P 〈0.01）. TNF-α was positively correlated with character and SCL-90 （r= 0.43, 0.82, 0.29, P 〈0.05, P 〈0.01）. [Conclusion]The patients with hyperthyroidism have indrawn, unstable and nervous personality, and also have some problems in emotion. Their mental health status in overall is poorer. Serum levels of IL-1, IL-6 and TNF-α have obvious changes in the pathogenesis of hyperthyroidism and are significantly correlated with the personality and mental health status of patients.