甲状腺激素水平与更年期综合征女性情绪障碍程度、性激素水平及免疫功能的相关性分析

Correlation analysis between thyroid hormone level and emotional disorder,sex hormone levels and immune function in climacteric syndrome women

目的探讨甲状腺激素水平与更年期综合征女性情绪障碍程度、性激素水平及免疫功能的相关性。方法前瞻性选取2017年8月至2020年1月间葫芦岛市中心医院首诊的更年期综合征妇女80例作为更年期综合征组,选取同期在本院进行常规体检的正常更年期女性100例作为正常对照组。比较2组妇女的血清甲状腺激素[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)]水平,性激素[雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)]水平,焦虑及抑郁情绪评分值,外周血T淋巴细胞亚群(CD3^+、CD4^+、CD8^+T淋巴细胞,CD4^+/CD8^+比值)分布情况的差异。采用Pearson检验评估更年期综合征组患者血清甲状腺激素水平与情绪障碍程度、性激素水平及免疫功能的相关性。结果更年期综合征组TSH、FT3、FT4、E2、LH、FSH、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、外周血CD3^+、CD4^+、CD8^+T淋巴细胞分布比率及CD4^+/CD8^+比值分别为(12.40±1.52)mU/L、(2.86±0.42)pmol/L、(14.22±1.61)pmol/L、(240.92±35.77)pmol/L、(7.30±0.85)mIU/mL、(6.48±0.81)mIU/mL、(45.19±6.20)分、(41.88±5.09)分、(44.37±5.60)%、(31.62±4.28)%、(33.91±4.85)%、0.95±0.11,对照组分别为(7.18±0.86)mU/L、(3.94±0.51)pmol/L、(20.74±4.38)pmol/L、(418.83±59.72)pmol/L、(11.74±1.83)mIU/mL、(9.03±0.97)mIU/mL、(36.28±5.10)分、(30.17±4.58)分、(47.10±5.87)%、(34.05±4.19)%、(30.43±4.20)%、1.12±0.15。更年期综合征组患者血清TSH水平、SAS评分、SDS评分、CD8^+T淋巴细胞分布比率均高于正常对照组,FT3水平、FT4水平、外周血CD3^+、CD4^+T淋巴细胞分布比率及CD4^+/CD8^+比值均低于正常对照组,差异有统计学意义(P<0.05)。相关性分析显示,更年期综合征患者血清甲状腺激素水平与情绪障碍程度、性激素水平及免疫功能相关性好(P<0.05)。结论更年期综合征患者血清甲状腺激素水平与情绪障碍程度、性激素水平及免疫功能直接相关。更年期综合征女性血清甲状腺激素水平紊乱可能是导致疾病发生、发展的重要原因之一。

Objective To investigate the correlation between thyroid hormone levels and mood disorder,sex hormone levels and immune function in climacteric syndrome women.Methods Eighty cases of climacteric syndrome women first diagnosed in Huludao Central Hospital during August 2017 to January 2020 were treated as climacteric syndrome group,and 100 normal menopausal women who underwent routine physical examination in Huludao Central Hospital during the same period were treated as normal control group.Two groups serum thyroid hormones[Thyroid stimulating hormone(TSH),free triiodothymogenic acid(FT3),free thyroxine(FT4)],level of anxiety and depression score values,sex hormones[estradiol(E2),luteinizing hormone(LH),follicle-stimulating hormone(FSH)]levels,peripheral blood T lymphocyte subsets[CD3^+,CD4^+,CD8^+T lymphocytes,CD4^+/CD8^+ratio]distribution difference were compared between two groups.Pearson test was used to evaluate the relationship between serum thyroid hormone levels and emotional disorder,sex hormone levels and immune function in patients with climacteric syndrome.Results In menopausal syndrome group TSH,FT3,FT4,E2,LH,FSH,SAS score,SDS score,peripheral blood CD3^+,CD4^+,CD8^+T lymphocyte distribution ratio and CD4^+/CD8^+ratio were respectively(12.40±1.52)mU/L,(2.86±0.42)pmol/L,(14.22±1.61)pmol/L,(240.92±35.77)pmol/L,(7.30±0.85)mIU/mL,(6.48±0.81)mIU/mL,(45.19±6.20)points,(41.88±5.09)points,(44.37±5.60)%,(31.62±4.28)%,(33.91±4.85)%,0.95±0.11.The control group were(7.18±0.86)mU/L,(3.94±0.51)pmol/L,(20.74±4.38)pmol/L,(418.83±59.72)pmol/L,(11.74±1.83)mIU/mL,(9.03±0.97)mIU/mL,(36.28±5.10)points,(30.17±4.58)points,(47.10±5.87)%,(34.05±4.19)%,(30.43±4.20)%,1.12±0.15.Serum TSH,scores of SAS and SDS and the distribution proportion of CD8^+T lymphocytes in climacteric syndrome group were higher than those in normal control group,the differences were statistically significant(P<0.05).The levels of FT3,FT4,E2,LH and FSH,distribution proportion of CD3^+,CD4^+T lymphocytes and the ratio of CD4^+/CD8^+in peripheral blood in climacteric syndrome group were lower than those in normal control group,the differences were statistically significant(P<0.05).Correlation analysis showed that serum thyroid hormone levels were directly correlated with emotion disorders,sex hormone levels and immune function in patients with climacteric syndrome(P<0.05).Conclusion Serum thyroid hormone levels in patients with menopausal syndrome are directly related to the degree of mood disorders,sex hormone levels and immune function.Disorder of serum thyroid hormone level may be one of the important reasons leading to the development of menopause syndrome.