改良电抽搐治疗对精神分裂症患者甲状腺素和性激素的影响

Effect of MECT on thyroxine and sex-hormone of patients with schizophrenia

目的探讨精神分裂症患者接受改良电抽搐治疗(MECT)后甲状腺素和性激素的变化。方法选择符合ICD-10诊断标准的精神分裂症患者52例,MECT治疗后30 min和疗程结束后分别检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、睾酮(T)、雌二醇(E2)及血清泌乳素(PRL)。治疗前后进行阳性和阴性症状量表(PANSS)评分,比较甲状腺素及性激素与PANSS评分的相关性。结果MECT治疗后30 min,甲状腺素无明显变化,差异无统计学意义(P>0.05);T、E2显著下降,PRL显著升高,差异有统计学意义(P<0.05)。MECT疗程结束后,T4和T下降,差异有统计学意义(P<0.05)。MECT治疗前后,T与阳性症状评分显著正相关(r=0.612,r=0.785,P<0.01),其他甲状腺素和性激素与PANSS评分各因子无相关性(P>0.05)。结论可以通过监测经MECT治疗的精神分裂症患者的甲状腺素水平及性激素水平,为临床医生观察疗效和调整治疗方案提供依据。

Objective To explore the changes of thyroxine and sex - hormone in patients with schizophrenia after accepting modified electroconvulsive therapy（MECT）. Methods 52 patients meeting the criteria of ICD - 10 for schizophrenia were se- lected to join the experiment. Three serum free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ）, thyroid stimulating hormone （TSH）, Three triiodothyronine（ T3 ）, thyroxine（ T4 ）, testosterone（ T）, estradiol（ E2 ） and serum prolactin（PRL） were tested after 30 min and at the end of treatment, respectively. Positive and negative syndrome scale（PANSS） was assessed before and after treatment, while the correlations among thyroxine, sex - hormone and scores of PANSS were analysed respectively. Results Thyroxine had no significant changes after treatment 30 min, and the difference had no statistical significance （P 〉 0.05）, levels of T and E2 significantly decreased, while level of PRL significantly increased, and the difference was statistically significant （ P 〈 0.05 ）. Levels of T4 and T significantly decreased after MECT （ P 〈 0.05 ）. There was significant positive correlation between T level and scores of positive syndrome before and after treatment （r =0.612, r=0.785, P 〈0.01 ）, while no correlation existed among other thyroxine, sex - hormone and scores of PANSS （P 〉 0.05）. Conclusion Clinical doctors could observe efficacy and adjust treatment through testing thyroxine and sex - hormone while curing patients with schizophrenia by MECT.