女性双相障碍患者共病甲状腺功能减退的危险因素

Risk factors of hypothyroidism comorbidity in female patients with bipolar disorder

目的:探讨女性双相障碍(BD)患者共病甲状腺功能减退(甲减)的危险因素。方法:根据基线期甲状腺激素水平将258例女性BD发作期患者分为甲状腺功能正常的非共病组(190例)及甲减的共病组(68例);对两组患者的人口学及临床资料、自杀风险量表(NGASR)评分、BD抑郁相患者的24项汉密尔顿抑郁量表(HAMD)评分及BD躁狂相患者的杨氏躁狂量表(YMRS)评分进行比较;采用Logistics回归分析BD患者共病甲减的危险因素。结果:共病组心境障碍家族史阳性率、非自杀性自伤行为发生率及NGASR评分明显高于非共病组(P<0.05或P<0.01);两组间锂盐使用时间差异有统计学意义(P<0.05);共病组的抑郁相患者的HAMD评分明显高于非共病组(P<0.01);两组间躁狂相患者的YMRS评分比较差异无统计学意义。Logistics回归分析显示,年龄、情感障碍家族史和使用锂盐时间与BD共病甲减有统计学意义(P<0.05或P<0.01)。结论:女性BD患者共病甲减的危险因素是年龄较大、情感障碍家族史阳性及锂盐使用时间较长。

Objective:To investigate the risk factors of comorbid hypothyroidism in female patients with bipolar disorder(BD).Method:258 female BD patients were divided into non-comorbid group(normal thyroid function group,n=190)and comorbid group(comorbid hypothyroidism group,n=68)according to thyroid hormone level at baseline.Demography,clinical data,Nurses'Global Assessment of Suicide Risk scale(NGASR)score,24-item Hamilton Depression Scale(HAMD)score in BD depressive phase and Mania Rating Scale(YMRS)score in BD manic phase were compared between the two groups.The risk factors of comorbidity hypothyroidism in BD patients were analyzed by Logistics regression.Results:The positive rate of family history of mood disorder,the incidence of non-suicidal self-injury and NGASR score in comorbidity group were significantly higher than those in non-comorbidity group(P<0.05 or P<0.01);statistically significant difference was observed in the time of lithium-taking between the two groups(P<0.05);the HAMD score of depressed patients in comorbidity group was significantly higher than that in non-comorbidity group(P<0.01).There was no significant difference in YMRS score between the two groups.Logistic regression analysis showed that age,family history of mood disorder and time of lithium-taking had statistical significances with BD comorbid hypothyroidism(P<0.05 or P<0.01).Conclusion:The risk factors of female BD patients with comorbidities of hypothyroidism are older age,positive family history of mood disorder and long time of lithium-taking.