抑郁症患者甲状腺激素和25-羟维生素D3水平及其临床意义

Levels of thyroid hormone and 25-hydroxyvitamin D3 and their clinical significance in patients with depression

目的探讨抑郁症患者甲状腺激素及25-羟维生素D 3[25-(OH)D 3]水平及其临床意义。方法选取82例抑郁症患者(病例组)及82例健康者(健康对照组),再将病例组随机分为病例观察组和病例对照组,每组41例。病例组均常规给予抗抑郁治疗,病例观察组加服维生素D 3。比较治疗前病例组与健康对照组之间以及不同病情程度抑郁症患者之间血清总三碘甲状腺原氨酸(TT 3)、游离三碘甲状腺原氨酸(FT 3)、总四碘甲状腺原氨酸(TT 4)、游离四碘甲状腺原氨酸(FT 4)、促甲状腺激素(TSH)、25-(OH)D 3水平。分析病例组汉密尔顿抑郁量表(HAMD)评分与血清甲状腺激素及25-(OH)D 3的相关性。比较治疗前后病例观察组和病例对照组HAMD评分。结果治疗前病例组血清TSH水平高于健康对照组;血清FT 4、TT 4、25-(OH)D 3水平低于健康对照组;重度抑郁患者TT 4、FT 4、25-(OH)D 3水平低于轻中度抑郁患者,TSH水平高于轻中度患者(均P<0.05)。抑郁症患者HAMD评分与TT 4、FT 4、25-(OH)D 3水平呈负相关,与TSH水平呈正相关(均P<0.05)。治疗后病例观察组HAMD评分低于病例对照组及治疗前水平(P<0.05)。结论抑郁症患者血清TT 4、FT 4、25-(OH)D 3水平降低,三者均与抑郁症的发生与发展密切相关,且补充维生素D可提高抑郁症的治疗效果。

Objective To investigate the levels of thyroid hormone and 25-hydroxyvitamin D 3[25-(OH)D 3]and their clinical significance in patients with depression.Methods Eighty-two patients with depression(case group)and 82 healthy individuals(healthy control group)were selected,then the case group was randomly divided into case observation group and case control group,with 41 cases in each group.The case group was given conventional anti-depression therapy,and the case observation group was given additional vitamin D 3.Serum total triiodothyronine(TT 3),free triiodothyronine(FT 3),total tetraiodothyronine(TT 4),free tetraiodothyronine(FT 4),thyroid-stimulating hormone(TSH)and 25-(OH)D 3 levels were compared between the case group and the healthy control group before treatment,or between patients with different severities of depression.The correlation of the Hamilton Depression Scale(HAMD)scores with serum thyroxine and 25-(OH)D 3 was analyzed.HAMD scores were compared between the case observation group and the case control group before and after treatment.Results Before treatment,the case group had higher serum TSH level and lower serum FT 4,TT 4 and 25-(OH)D 3 levels than the healthy control group;patients with severe depression experienced lower levels of TT 4,FT 4 and 25-(OH)D 3 but higher TSH level as compared with patients with mild to moderate depression(all P<0.05).HAMD scores negatively correlated with TT 4,FT 4 or 25-(OH)D 3 level in patients with depression,but positively correlated with TSH level(all P<0.05).After treatment,HAMD scores in the case observation group were lower than those in the case control group or before treatment(P<0.05).Conclusion Patients with depression exhibit decreased levels of serum TT 4,FT 4 and 25-(OH)D 3,and the three indices all closely correlate with the development and progression of depression,and vitamin D supplementation can improve the therapeutic effect on depression.