双相障碍不同心境发作期患者血清甲状腺激素和性激素研究

Thyroid and sex hormones changes during depressive,manic and mixed episode of the patients with bipolar disorder

目的探讨双相障碍患者不同心境发作期的甲状腺激素和性激素水平差异及其与疾病状态的关系。方法纳入双相障碍患者795例,包括抑郁发作352例、躁狂发作476例、混合发作67例,收集患者入院后首次甲状腺功能和性激素的血液检查结果。结果三组患者的游离三碘甲状腺原氨酸、游离甲状腺素、三碘甲状腺原氨酸、甲状腺素、促甲状腺激素、垂体泌乳素(男性和女性)水平均存在统计学差异(P<0.05)。与抑郁发作组相比,躁狂发作组中三碘甲状腺原氨酸水平异常者较少(OR=0.48),躁狂发作男性患者(OR=1.91)和女性患者(OR=1.85)中垂体泌乳素水平异常者均较多(P<0.05)。结论双相障碍患者三碘甲状腺原氨酸、垂体泌乳素水平异常可能与抑郁、躁狂发作状态有关。

Objective To explore thyroid and sex hormones of patients with bipolar disorder in different cardiac stages(depression,mania and mixed episodes),as well as their correlations.Methods A total of 795 electronic medical records of first hospitalized patients who met the ICD-10 F31 bipolar disorder diagnosis criteria were included.Patients were divided into three groups including depressive episodes(352 patients),manic episodes(476 patients)and mixed episodes(67 patients)group according to the discharge diagnosis.The data of hematological examination was collected including free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),thyroxine(T4),triiodothyronine(T3),testosterone(T)and prolactin(PRL).Results FT3,FT4,T3,T4,TSH and PRL(both male and female)showed significant difference among depressive,manic and mixed episodes of patients with bipolar disorder.Compared with depressive group,fewer patients had abnormal T3 level(OR=0.48)in manic group(P<0.05).Both male(OR=1.91)and female(OR=1.85)patients had higher PRL level in manic group(P<0.05).Conclusion The abnormal levels of T3 and prolactin in patients with bipolar disorder are highly related to depressive and manic status.