血清甲状腺激素和hs-CRP在难治性抑郁症患者中的表达情况及与病情严重程度的相关性

The expression of serum thyroid hormone and hs-CRP in patients with treatment-resistant depression and their correlation with the severity of the disease

目的分析血清甲状腺激素和超敏C反应蛋白(hs-CRP)在难治性抑郁症(TRD)患者中的表达情况及与病情严重程度的相关性。方法选取2019年2月至2020年12月我院收治的120例抑郁症患者,根据疾病类型将其分为TRD组(60例,TRD)和非难治性抑郁症(NTRD)组(60例,NTRD);同时纳入60例正常体检的健康人群作为健康对照组。检测研究对象的血清甲状腺激素[游离三碘甲状腺原氨酸(FT_(3))、游离四碘甲腺原氨酸(FT_(4))、促甲状腺激素(TSH)]及hs-CRP水平。比较三组的甲状腺激素及hs-CRP水平;比较TRD组不同严重程度患者的甲状腺激素及hs-CRP水平;分析TRD组甲状腺激素和hs-CRP水平与抑郁症患者病情严重程度的相关性。结果TRD组、NTRD组和健康对照组的FT_(3)、FT_(4)、TSH、hs-CRP水平比较,差异具有统计学意义(P<0.05);TRD组和NTRD组的FT_(3)、FT_(4)、TSH水平低于健康对照组,hs-CRP水平高于健康对照组,差异具有统计学意义(P<0.05);TRD组的FT_(3)、FT_(4)水平低于NTRD组,hs-CRP水平高于NTRD组,差异具有统计学意义(P<0.05)。TRD组不同严重程度患者的FT_(3)、FT_(4)、hs-CRP水平比较,差异具有统计学意义(P<0.05);TRD组不同严重程度患者的TSH水平比较,差异无统计学意义(P>0.05);重度抑郁组和中度抑郁组的FT_(3)、FT_(4)水平低于轻度抑郁组,hs-CRP水平高于轻度抑郁组,差异具有统计学意义(P<0.05);重度抑郁组的FT_(3)、FT_(4)水平低于中度抑郁组,hs-CRP水平高于中度抑郁组,差异具有统计学意义(P<0.05)。Spearman相关性分析结果显示,TRD组患者的FT_(3)、FT_(4)水平与病情严重程度呈负相关(r=-0.630、-0.632,P<0.05),hs-CRP水平与病情严重程度呈正相关(r=0.643,P<0.05)。结论TRD患者的血清FT_(3)、FT_(4)及hs-CRP水平与病情严重程度具有相关性,检测患者甲状腺激素及hs-CRP水平,有利于掌握其病情严重程度与发展状况,可为临床的干预治疗提供参考依据。

Objective To analyze the expression of serum thyroid hormone and hypersensitive C-reactive protein(hs-CRP)in patients with treatment-resistant depression(TRD)and their correlation with the severity of the disease.Methods A total of 120 patients with depression admitted in our hospital from February 2019 to December 2020 were selected and divided into TRD group(60 cases,TRD)and non-treatment-resistant depression(NTRD)group(60 cases,NTRD)according to the type of disease;at the same time,60 healthy people with normal physical examination were included as healthy control group.The levels of serum thyroid hormones[free triiodothyronine(FT_(3)),free tetraiodothyronine(FT_(4)),thyroid stimulating hormone(TSH)]and hs-CRP of objects were detected.The levels of thyroid hormones and hs-CRP in the three groups were compared;the levels of thyroid hormones and hs-CRP in patients with different severity of the TRD group were compared;the correlation between the levels of thyroid hormones,hs-CRP and the severity of depression in the TRD group were analyzed.Results The levels of FT_(3),FT_(4),TSH and hs-CRP in the TRD group,the NTRD group and the healthy control group were significantly different(P<0.05);the levels of FT_(3),FT_(4) and TSH in the TRD group and the NTRD group were lower than those in the healthy control group,the level of hs-CRP was higher than that in the healthy control group,and the differences were statistically significant(P<0.05);the levels of FT_(3) and FT_(4) in the TRD group were lower than those in the NTRD group,the level of hs-CRP was higher than that in the NTRD group,and the differences were statistically significant(P<0.05).The levels of FT_(3),FT_(4) and hs-CRP in patients with different severity of the TRD group were significantly different(P<0.05);there was no significant difference in TSH level between patients with different severity in the TRD group(P>0.05);the levels of FT_(3) and FT_(4) in the severe depression group and the moderate depression group were lower than those in the mild depression group,the level of hs-CRP was higher than that in the mild depression group,and the differences were statistically significant(P<0.05);the levels of FT_(3) and FT_(4) in the severe depression group were lower than those in the moderate depression group,the level of hs-CRP was higher than that in the moderate depression group,and the differences were statistically significant(P<0.05).Spearman correlation analysis results showed that the levels of FT_(3) and FT_(4) in the TRD group were negatively correlated with the severity of the disease(r=-0.630,-0.632,P<0.05),and the level of hs-CRP was positively correlated with the severity of the disease(r=0.643,P<0.05).Conclusion The levels of serum FT_(3),FT_(4) and hs-CRP in TRD patients are correlated with the severity of the disease.The detection of thyroid hormones and hs-CRP levels in patients is helpful to grasp the severity and development of the disease,and can provide reference for clinical intervention.