双相情感障碍躁狂发作患者垂体泌乳素与甲状腺轴的关系分析

Analysis of the Relationship between Pituitary Prolactin and Thyroid Axis in Patients with Bipolar Disorder Manic Episodes

目的:分析双相情感障碍躁狂发作患者垂体泌乳素(PRL)与甲状腺轴变化水平,为临床诊治提供参考。方法:选取2018年4月—2019年10月驻马店市第二人民医院就诊作为43例双相情感障碍躁狂症患者作为观察组,选取同期体检正常的41例健康者作为对照组,测定两组患者PRL及甲状腺功能指标[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、三碘甲状腺原氨酸(TT3)、总甲状腺激素(TT4)],比较两组男性、女性PRL水平与甲状腺功能指标,采用一般线性双变量Pearson相关性检验分析双相情感障碍躁狂发作患者垂体泌乳素与甲状腺轴的关系。结果:两组男性PRL、TSH、FT3、FT4、TT3、TT4水平对比,差异无统计学意义(t=0.886、0.441、0.062、0.070、0.092、0.543,P>0.05);观察组女性PRL、TSH水平较对照组女性高,FT4、TT3、TT4水平较对照组女性低,差异有统计学意义(t=186.840、3.491、6.296、3.210、7.691,P<0.05)。经双变量Pearson相关性分析检验证实,双相情感障碍躁狂发作女性患者PRL与TSH呈正相关(r=0.523,P<0.05),与FT3、FT4、TT3、TT4呈负相关(r=-0.385、-0.715、-0.449、-0.727,P<0.05),而男性患者PRL与TSH、FT3、FT4、TT3、TT4无相关性(r=0.042、0.029、0.011、0.008、0.056,P>0.05)。结论:双相情感障碍躁狂发作女性患者PRL水平与TSH呈正相关,与FT3、FT4、TT3、TT4水平呈负相关,男性患者PRL水平与甲状腺轴无相关性,或可为女性患者治疗提供一定参考。

Objective:To analyze the change level of pituitary lactogen(PRL)and thyroid axis in patients with bipolar disorder manic episodes.Methods:43 patients with bipolar disorder mania who attended the hospital from April 2018 to October 2019 were selected as the observation group,and 41 healthy individuals with normal physical examination during the same period were selected as the control group.The pituitary PRL and thyroid function indexes(thyroid stimulating hormone[TSH],free triiodothyro⁃nine[FT3],free thyroid hormone[FT4],triiodothyronine[TT3],total thyroid hormone[TT4])were measured in both groups,and the PRL levels and thyroid function indexes were compared between the two groups in men and women.The general linear bivariate Pearson correlation test was used to analyze the relationship between pituitary lactogen and the thyroid axis in patients with bipolar disorder manic episodes.Results:There was no statistically significant difference in the levels of PRL,TSH,FT3,FT4,TT3 and TT4 between the two groups of men(t=0.886,0.441,0.062,0.070,0.092,0.543,P>0.05).Women in the observation group had higher levels of PRL and TSH and lower levels of FT4,TT3 and TT4 levels than women in the control group,with statistically sig⁃nificant differences(t=186.840,3.491,6.296,3.210,7.691,P<0.05).The bivariate Pearson correlation analysis test confirmed that PRL was positively correlated with TSH(r=0.523,P<0.05)and negatively correlated with FT3,FT4,TT3,TT4(r=-0.385,-0.715,-0.449,-0.727,P<0.05).In contrast,there was no correlation between PRL and TSH,FT3,FT4,TT3,TT4 in male patients(r=0.042,0.029,0.011,0.008,0.056,P>0.05).Conclusion:PRL levels were positively correlated with TSH and neg⁃atively correlated with FT3,FT4,TT3 and TT4 levels in female patients with bipolar disorder manic episode,and PRL levels were not correlated with the thyroid axis in male patients,which may provide some reference for the treatment of female pa⁃tients.