抑郁症首次发病与复发患者甲状腺激素水平的研究

The research of serum thyroid hormones levels in first-episode and recurrent depressive patients

目的：探讨甲状腺激素水平与首发和复发抑郁症之间的相关性及临床意义。方法：采用电化学发光免疫分析法，分别测定127例抑郁症患者（其中首发抑郁组66例、复发抑郁组61例）和53名正常者（正常对照组）的血清三碘甲状腺原氨酸（ T3）、甲状腺素（ T4）、游离甲状腺激素（ FT3、FT4）和促甲状腺激素（ TSH）水平；采用汉密尔顿抑郁量表（ HAMD）评估患者抑郁程度。结果：复发抑郁组血清FT3水平显著低于正常对照组（ P=0.009），血清T3、T4、FT4、TSH水平与正常对照组差异无统计学意义；首发抑郁组血清T3、T4、FT3、FT4、TSH水平与正常对照组差异无统计学意义。相关分析显示，首发抑郁组血清T3水平与HAMD总分呈负相关（ r=-0.250，P=0.043）；复发抑郁组血清T3、T4、FT3、FT4、TSH与HAMD总分均无相关（r=0.014~0.204，P均＞0.05）。结论：抑郁症首次发病与复发患者血清甲状腺激素水平存在一定变化，复发较首发抑郁者可能存在更严重的甲状腺功能减退。

Objective：To explore the relationship between serum thyroid hormones levels and major de-pression and clinical significance. Method：The serum triiodothyronine（ T3 ）,thyroxin（ T4 ）,free-triiodothy-ronine（T3）,thyroxin（T4）and thyroid stimulating hormone（TSH）levels were measured by electrochemilumi-nescence immunoassay in 127 depressive patients（ 66 cases in first-episode group and 61 cases in recurrent group）and 53 healthy controls（ normal control group ）. The degree of depression of all the patients were as-sessed by Hamilton depression scale（ HAMD）. Results：The serum FT3 level in recurrent group was signifi-cantly lower than that in normal control group（P=0.009）.There were no significant differences in serum T3, T4,FT4 and TSH levels between recurrent group and normal control group.No significant differences were found in serum T3,T4,FT3,FT4 and TSH levels between first-episode group and normal control group.Correlation a-nalysis indicated that the total scores of HAMD were negatively associated with serum T3 levels in first-episode group（r= -0.250,P=0.043）.The total scores of HAMD were not related to serum T3,T4,FT3,FT4,TSH levels in recurrent group（r=0.014~0.204,all P〉0.05）. Conclusion：The changes of serum thyroid hor-mones level were found in first-episode and recurrent depressive patients,and recurrent depressive patients may have more severe thyroid dysfunction.