心理干预对2型糖尿病伴抑郁患者甲状腺激素水平的影响

The Effect of Psychological Intervention on Thyroid Hormone Levels in Type 2 Diabetes Patients with Depression

目的探讨心理干预对2型糖尿病(T2DM)伴抑郁症患者血清甲状腺激素水平的影响。方法选取186例T2DM患者为研究对象,采用抑郁评定量表(SDS)得分对患者进行测评诊断,根据诊断结果分为T2DM伴抑郁症患者101例和T2DM不伴抑郁症患者85例。其中将T2DM伴抑郁症患者随机分为心理干预组(常规护理+心理干预)和对照组(常规护理)。结果 1 T2DM伴抑郁症的患病率为56.99%。2与T2DM不伴抑郁症组比较,T2DM伴抑郁症组患者血清游离三碘甲状腺原氨酸(FT3)水平明显降低(P<0.01),促甲状腺激素(TSH)水平明显升高(P<0.01)。3心理干预后T2DM伴抑郁症患者血清FT3水平较干预前明显升高(t=2.052,P=0.031);TSH水平、SDS评分较干预前均明显降低(P<0.001)。结论在糖尿病伴抑郁症患者人群中存在甲状腺激素代谢紊乱,心理干预有益于调节甲状腺激素代谢。

Objective To investigate the effect of psychological intervention on thyroid hormone levels in type 2 diabetes （T2DM） patients with depression. Methods Self-rating depression scale （SDS） score was used for assessing depression severity among patients. In all, 186 T2DM patients were recruited to the study, which included 101 T2DM patients with depression and 85 T2DM patients without depression. And T2DM patients with depression were randomly divided into psychological intervention group （usual care ＋ psychological intervention） and control group （usual care）. Results ①The frequency of T2DM patients with depression in the study participants was 56.99%. ②Compared with T2DM patients without depression, subjects with depression had significantly lower serum free thyroid original three iodine glycine （FT3） levels and higher serum thyroid stimulating hormone （TSH） level （all P〈0.01）. ③ FT3 level was increased significantly in T2DM patients with depression （t=2.052, P=0.031 ） , while TSH level and SDS scores decreased significantly after the psychological intervention （P〈0.001）. Conclusion Disorders of thyroid hormone metabolism were observed in T2DM patients with depression. Psychological intervention may play an important role in regulating thyroid hormone metabolism.