碳酸锂对双相障碍患者甲状腺功能的影响

Correlation of lithium treatment and thyroid function in patients with bipolar disorders

目的探讨碳酸锂对双相障碍患者甲状腺功能的影响。方法将符合《国际疾病分类(第10版)》(ICD-10)双相障碍诊断标准的65例双相障碍患者给予碳酸锂治疗3个月。分别在治疗前和治疗3个月检测血浆游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)和促甲状腺激素(TSH)水平。结果 1锂盐治疗后血浆T3(1.62±0.34nmol/L)、T4(97.08±19.81)水平低于治疗前,TSH(2.77±1.27mIU/L)高于治疗前水平,差异有统计学意义(P<0.01);2锂盐治疗后女性血浆T3水平(1.52±0.37 nmol/L)低于男性,TSH水平(3.26±1.38 mIU/L)高于男性,差异有统计学意义(P<0.01);3相关分析显示,在控制性别和病程的影响后,锂盐治疗剂量依然与血浆T3水平呈正相关(r=0.35,P=0.005)。结论锂盐可能对双相障碍患者甲状腺功能改变存在影响。

Objective To determine the correlation of lithum and thyroid function in patients with bipolar disorder. Methods 65 patients wit lithum treatment were tested all plasma biomarkers of thyroid function respectively at the baseline and 3 months end- point. Results ①There were significantly lower T3 level （ 1.62±0. 34nmol/L）, T4 level （97.08 ± 19.81 ） and higher TSH level （2.77 ±1.27mIU/L） after lithum treatment than at baseline （ P 〈 0.01 ） ;②There were significant difference between gender after lithum treatment, there were lower T3 level （ 1.52 ±0.37 nmol/L）, and higher TSH level （3.26 ± 1.38 mIU/L）in female patients than in male patients（ P 〈 0.01 ） ;③The correlation analysis showed the lithum treatment may be mainly correlated with T3 level （r = 0. 35, P = 0.005 ） after controlling gender and duration confounding. Conclusion Lithum treatment may be associated with changing thyroid function in patients with bipolar disorder.