双相障碍抑郁发作及单相抑郁症患者血清T3、T4、TSH和BDNF水平的相关性分析

Correlation Analysis of Serum T3,T4,TSH and BDNF Levels in Patients with Bipolar Disorder and Unipolar Depression

目的:分析双相障碍抑郁发作及单相抑郁症患者与血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、甲状腺激素(TSH)和脑源性神经营养因子(BDNF)水平的相关性。方法:选取2017年12月~2019年12月我院收治的120例抑郁症患者为研究对象,按照病情不同分为双相障碍抑郁发作组(n=50)、单相抑郁症组(n=70),同时选取同期于本院进行体检的30例健康者作为对照组,检测血清T3、T4、TSH和BDNF水平,并进行汉密尔顿抑郁(HAMD)量表评分,分析血清T3、T4、TSH和BDNF水平的相关性。结果:双相障碍抑郁发作组起病年龄低于单相抑郁症组(P<0.05);治疗前双相障碍抑郁发作组和单相抑郁症组血清T3水平高于对照组,TSH、BDNF水平低于对照组(P<0.05),双相障碍抑郁发作组血清T4水平高于对照组,单相抑郁症组和对照组血清T4水平比较差异无统计学意义(P>0.05),双相障碍抑郁发作组血清T4水平高于单相抑郁症组,TSH、BDNF水平低于单相抑郁症组(P<0.05);治疗后双相障碍抑郁发作组和单相抑郁症组血清T4水平低于对照组,双相障碍抑郁发作组血清T4水平低于单相抑郁症组(P<0.05),且三组血清T3、TSH、BDNF水平比较差异无统计学意义(P>0.05);治疗后双相障碍抑郁发作组认知障碍因子评分低于单相抑郁症组(P<0.05);Spearman相关分析显示,血清T3、T4、TSH水平和HAMD评分与BDNF呈负相关,TSH水平与BDNF呈正相关(P<0.05)。结论:抑郁症患者血清T3、T4、TSH和BDNF水平存在异常,可作为判断双相障碍抑郁发作及单相抑郁症的指标。

Objective:To analyze the correlation between serum levels of triiodothyronine(T3),thyroxine(T4),thyroid-stimulating hormone(TSH)and brain-derived neurotrophic factor(BDNF)in patients with bipolar depressive episode and unipolar depression.Methods:A total of 120 patients with depression admitted to our hospital from December 2017 to December 2019 were selected as research objects,Which were divided into bipolar depressive episode group(n=50),unipolar depression group(n=70)according to the condition of different,at the same time,30 healthy people who had physical examination in our hospital at the same time were selected as the control group.The levels of serum T3,T4,TSH and BDNF were detected,and the scores of Hamilton Depression Scale(HAMD)were evaluated.The correlation between the levels of serum T3,T4,TSH and BDNF was analyzed.Results:The age of onset of bipolar depressive episode group was lower than that of unipolar depression group(P<0.05).Before treatment,the serum T3 level of bipolar depressive episode group and unipolar depression group was higher than that of the control group,the serum TSH and BDNF level was lower than that of the control group(P<0.05),the serum T4 level of bipolar depressive episode group was higher than that of the control group,the serum T4 level of unipolar depression group and the control group was not significantly different(P>0.05),the serum T4 level of bipolar depressive episode group was higher than that of unipolar depression group(P<0.05),and the levels of TSH and BDNF were lower than that of unipolar depression group(P<0.05).After treatment,the serum T4 level of bipolar depressive episode group and unipolar depression group was lower than that of the control group,and the serum T4 level of bipolar depressive episode group was lower than that of unipolar depression group(P<0.05),and there was no significant difference in the serum T3,TSH and BDNF levels among the three groups(P>0.05);the cognitive impairment factor score of bipolar depressive episode group was lower than that of unipolar depression group(P<0.05).Spearman correlation analysis showed that serum T3,T4,TSH levels and HAMD scores were negatively correlated with BDNF,and TSH levels were positively correlated with BDNF(P<0.05).Conclusion:The levels of T3,T4,TSH and BDNF in patients with depression are abnormal,which can be used as an index to judge the onset of bipolar depressive episode and monophasic depression.