精神分裂症合并抑郁患者血清甲状腺激素、脑源性神经营养因子水平变化及临床意义

Changes of Serum Thyroid Hormone and Brain-derived Neurotrophic Factor Levels in Patients with Schizophrenia Complicated with Depression and Its Clinical Significances

目的分析精神分裂症合并抑郁患者血清甲状腺激素、脑源性神经营养因子(BDNF)水平变化及临床意义。方法回顾性分析2019年2月—2020年8月收治的精神分裂症122例的临床资料,并按照有无合并抑郁,设为未合并组59例,合并组63例。其中合并组轻度20例、中度26例、重度17例。另选取75例健康体检者作为对照组。对比3组血清BDNF、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)水平,分析精神分裂症合并抑郁患者BDNF、FT_(3)、FT_(4)、TSH水平与汉密尔顿抑郁量表(HAMD)评分的相关性。结果合并组血清BDNF、FT_(3)、TSH水平低于未合并组和对照组,且未合并组低于对照组(P<0.05)。轻度组血清BDNF、FT_(3)、TSH水平高于中度组和重度组,且中度组高于重度组(P<0.05)。精神分裂症合并抑郁患者BDNF、FT_(3)、TSH水平与HAMD评分呈负相关(r=-0.638、-0.614、-0.572,P<0.05)。结论精神分裂症合并抑郁患者血清BDNF、FT_(3)、TSH表达下调,且与患者抑郁程度相关。

Objective To analyze the changes and clinical significances of serum thyroid hormone and brain-derived neurotrophic factor(BDNF)levels in patients with schizophrenia and depression.Methods The clinical data of 122 patients with schizophrenia who were treated from February 2019 to August 2020 was retrospectively analyzed,and according to the presence or absence of depression,they were divided into the non-combination group(n=59)and the combination group(n=63).In the combination group,20 were mild,26 were moderate,and 17 were severe.Another 75 healthy physical examinees were selected as the control group.The serum levels of BDNF,free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),and thyroid-stimulating hormone(TSH)in the three groups were compared,and the correlation of the levels of BDNF,FT_(3),FT_(4),and TSH with HAMD score in schizophrenia patients with depression was analyzed.Results The levels of serum BDNF,FT_(3) and TSH in the combination group were lower than those in the non-combination group and the control group,and lower in the non-combination group than in the control group(P<0.05).The levels of serum BDNF,FT_(3) and TSH in the mild group were higher than those in the moderate and severe groups,and higher in the moderate group than in the severe group(P<0.05).The levels of BDNF,FT_(3) and TSH in schizophrenia patients with depression were negatively correlated with HAMD score(r=-0.638,-0.614,-0.572,P<0.05).Conclusion The expressions of BDNF,FT_(3) and TSH in the serum of patients with schizophrenia complicated by depression were down-regulated,which were related to the severity of depression of the patients.