育龄期女性双相障碍躁狂发作患者甲状腺激素表达水平

Expression Level of Thyroid Hormone in Manic Episode of Bipolar Disorder in Women of Childbearing Age

目的探讨育龄期女性双相障碍躁狂发作时的甲状腺激素水平。方法选取2018年12月至2020年8月郑州市第八人民医院收治的126例育龄期女性双相障碍躁狂发作患者为研究组,并分为服药组(64例)和无药组(62例),抽取同期进行体检的125名健康育龄期女性志愿者作为对照组,以催乳素(PRL)为协变量对甲状腺激素水平进行分析,采用杨氏躁狂量表(YMRS)评定躁狂症状,分析甲状腺激素水平与躁狂症状的相关程度。结果研究组的总甲状腺素(TT_(4))、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平均较对照组升高(F=39.381、21.211、71.386,P<0.01),总三碘甲腺原氨酸(TT_(3))水平下降(F=10.000,P<0.01),无药组的TT_(4)、FT_(4)水平较服药组升高(F=4.214、9.537,P<0.05)。FT_(3)水平与思维内容呈正相关(r=0.178,P<0.05),FT_(4)水平与YMRS总分、心境障碍、睡眠、语言速度和数量、思维内容、语言思维形式障碍均呈正相关(r=0.277、0.185、0.190、0.247、0.286、0.373,P<0.05);促甲状腺激素(TSH)水平与YMRS总分、语言思维形式障碍、语言速度和数量、睡眠、性兴趣、活动精力增加、心境障碍均呈负相关(r=-0.184、-0.268、-0.192、-0.256、-0.216、-0.296、-0.283,P<0.05)。结论育龄期女性双相障碍躁狂发作患者血清甲状腺激素水平存在异常,且躁狂症状严重程度与血清FT_(4)、FT_(3)和TSH水平相关,可能会对生育功能产生影响。

Objective To investigate the thyroid hormone level in manic episode of bipolar disorder in women of childbearing age.Methods A total of 126 female patients with manic episodes and bipolar disorder of childbearing age who were treated in Zhengzhou Eighth People’s Hospital from December 2018 to August 2020 were selected as the study group,and they were divided into drug taking group(64 cases)and drug free group(62 cases).And 125 healthy female volunteers of childbearing age who underwent physical examination during the same time were selected as the control group.The thyroid hormone level was analyzed with pituitary prolactin(PRL)as the covariate,and the manic symptoms were evaluated by Young mania rating scale(YMRS).To analyze the correlation between thyroid hormone level and manic symptoms.Results The levels of total thyroxine(TT_(4)),free triiodothyronine(FT_(3))and free thyroxine(FT_(4))in the study group were higher than those in the control group(F=39.381,21.211,71.386,P<0.01).The level of total triiodothyronine(TT_(3))decreased(F=10.000,P<0.01).The levels of TT_(4)and FT_(4)in the drug free group were higher than those in the drug taking group(F=4.214,9.537,P<0.05).FT_(3)level was positively correlated with thinking content(r=0.178,P<0.05),FT_(4)level was positively correlated with YMRS total score,mood disorder,sleep,language speed and quantity,thinking content,language thinking form disorder(r=0.277,0.185,0.190,0.247,0.286,0.373,P<0.05).The level of thyroid stimulating hormone(TSH)was negatively correlated with the total score of YMRS,language thinking form disorder,language speed and quantity,sleep,sexual interest,increased activity energy and mood disorder(r=-0.184,-0.268,-0.192,-0.256,-0.216,-0.296,-0.283,P<0.05).Conclusion There is abnormal thyroid hormone level in female patients with manic episode of bipolar disorder at childbearing age,and the severity of manic symptoms is related to the levels of serum FT_(4),FT_(3)and TSH,which may affect fertility.