不同首发症状双相障碍患者的甲状腺水平研究

The thyroid levels of patients of bipolar disorder with different onset symptoms

目的探究不同首发症状双相障碍患者甲状腺水平情况。方法 352例双相障碍首发患者按照病理特征分为抑郁组163例和躁狂组(躁狂/轻躁)189例,统计2组患者的临床资料,记录发病症状,比较2组患者的甲状腺激素水平。结果躁狂组女性106例(41.71%),疾病的确诊年龄为29.37±3.48岁,抑郁症发作次数为1.69±1.02次;抑郁组女性106例(56.08%),疾病确诊年龄为30.40±3.53,抑郁症发作次数为2.84±1.31次;2组差异均具有统计学意义(P<0.05)。抑郁组缓解期T4水平和发作期FT3、T3、FT4水平均低于躁狂组,差异具有统计学意义(P<0.05);对患者缓解期甲状腺功能指标与HAMD评分的偏相关分析显示:缓解期TSH、FT3、T3、FT4与总分以及各因子分之间无相关性(P<0.05),但T4与总分以及各因子分之间呈现正相关性(P<0.05)。结论不同首发症状的双相障碍患者具有不同的甲状腺水平,在治疗时应采取不同的方式。

Objective To examine the thyroid levels in patients of bipolar disorder with different onset symptoms.Methods352 patients of bipolar disorder were firstly divided into two groups,namely,depression group（n=163） and manic group（n=189）,according to pathological features.Secondly,the clinical data of the patients were documented and the symptoms of the patients were recorded.The thyroid hormone levels were then compared between the two groups.Findings Of the manic group,106（41.71%） cases were found to be female.The age of diagnosis was 29.37±3.48 years old.The number of depression episodes was 1.69±1.02 times.The number of female patients in the depression group was 106 cases（56.48%）.The age of diagnosis was 30.40±3.53,and the number of depressive episodes was 2.84±1.31 times.The differences were statistically significant（P〈0.05）.The level of T4 in the depression group during remission was 69.25± 3.02 nmol/L and the levels of FT3,T3 and FT4 of the depression group were lower than those of the manic group.The differences were statistically significant（P〈0.05）.The relationship between thyroid function index and HAMD score in patients with remission was analyzed.The TSH,FT3,T3,FT4 and total score of the remission period were analyzed.There was no significant difference between the two groups（P〈0.05）.However,there was significant difference between T4 and total score and the scores of each factor（P〈0.05）.Conclusion Patients with bipolar disorder with different initial symptoms have different thyroid levels and should be subjected to differentiated treatment.