首发双相情感障碍躁狂发作患者促甲状腺激素与垂体泌乳素的相关性分析

Correlation analysis of thyroid stimulating hormone and pituitary prolactin in patients with manic episode of first episode bipolar disorder

目的探讨首发双相情感障碍(BD)躁狂发作患者甲状腺激素指标水平变化及其促甲状腺激素(TSH)与垂体泌乳素(PRL)的相关性。方法选取2019年1月至2021年6月本院收治的40例首发BD狂躁发作患者作为病例组,选取同期从社会招募的40名健康者作为对照组,检测两组甲状腺激素指标[TSH、总甲状腺素(TT_(4))、游离三碘甲状腺原氨酸(FT_(3))、总三碘甲状腺原氨酸(TT_(3))、游离甲状腺素(FT_(4))]、PRL水平。比较两组TSH、PRL水平正常与异常比例,比较两组及不同性别TSH、PRL水平正常与异常比例,比较两组及不同性别甲状腺激素指标及PRL水平,运用线性回归、曲线拟合分析双相障碍躁狂发作患者TSH与PRL水平的相关性。结果两组TSH、PRL水平正常比例均高于异常比例,差异有统计学意义(P<0.05);病例组TSH、PRL水平正常比例均低于对照组,而异常比例高于对照组,差异有统计学意义(P<0.05)。病例组男性TSH水平正常比例高于对照组,异常比例低于对照组(P<0.05);病例组女性TSH、PRL水平正常比例均低于对照组,异常比例均高于对照组(P<0.05)。病例组TT_(3)、TT_(4)水平均明显低于对照组(P<0.05);病例组女性TSH、PRL水平均高于对照组女性,而TT_(3)、TT_(4)水平均低于对照组女性(P<0.05);病例组男性TT_(4)水平低于对照组男性(P<0.05)。线性回归分析显示,病例组女性PRL与TSH呈线性相关(r^(2)=0.132,F=4.336,P<0.01),且曲线拟合分析显示,病例组女性PRL与TSH存在逆函数关系(r^(2)=0.252,F=9.374,P<0.01),其方程式y=b_(0)+b_(1)/x(b_(0)=291.55,b_(1)=793.96)。结论首发BD躁狂发作患者TSH水平存在性别差异,性别可能会导致垂体前叶激素分泌的代偿功能出现异常,且女性首发BD躁狂发作患者PRL、TSH水平升高可能会增加躁狂期发病风险,但PRL与TSH间分泌可能呈逆函数关系。

Objective To investigate the changes of thyroid hormone indexes and the correlation between thyroid stimulating hormone(TSH)and pituitary prolactin(PRL)in patients with manic episode of first episode bipolar disorder(BD).Methods 40 patients with manic episode of first episode BD admitted to our hospital from January 2019 to June 2021 were selected as the case group,and 40 healthy people were recruited from society during the same period were selected as the control group.The levels of thyroid hormone indexes(TSH,total thyroxine[TT_(4)],free triiodothyronine[FT_(3)],total triiodothyronine[TT_(3)],free thyroxine[FT_(4)])and PRL were detected in the two groups.The proportion of normal and abnormal levels of TSH and PRL between the two groups and different genders was compared,and the thyroid hormone indexes and PRL levels were compared between the two groups and different genders.Linear regression and curve fitting were used to analyze the correlation between TSH and PRL levels in patients with bipolar manic episodes.Results The normal proportions of TSH and PRL levels in the two groups was higher than the abnormal proportions,and the difference was statistically significant(P<0.05);The normal proportions of TSH and PRL levels in the case group were lower than those in the control group,while the abnormal proportions were higher than those in the control group,and the difference was statistically significant(P<0.05).The normal proportion of male TSH level in the case group was higher than that in the control group,and the abnormal proportion was lower than that in the control group(P<0.05);The normal proportions of female TSH and PRL levels in the case group were lower than those in the control group,and the abnormal proportions were higher than those in the control group(P<0.05).The levels of TT_(3) and TT_(4) in the case group were significantly lower than those in the control group(P<0.05);the levels of famale TSH and PRL in the case group were higher than those in the control group,while the levels of TT_(3) and TT_(4) were lower than those in the control group(P<0.05);the level of TT_(4) in males of the case group was lower than that the control group(P<0.05).Linear regression analysis showed that there was a linear correlation between female PRL and TSH in the case group(r^(2)=0.132,F=4.336,P<0.01),and curve fitting analysis showed that there was an inverse functional relationship between female PRL and TSH in the case group(r^(2)=0.252,F=9.374,P<0.01),its equation y=b_(0)+b_(1)/x(b_(0)=291.55,b_(1)=793.96).Conclusion There are gender difference in TSH levels in patients with manic episode of first episode BD,gender may lead to abnormal compensation function of anterior pituitary hormone secretion,increased levels of PRL and TSH in female patients with manic episode of first episode BD may increase the risk of manic onset,but there may be an inverse functional relationship between PRL and TSH secretion.