双相情感障碍患者执行功能与血清催乳素、甲状腺功能的关系

Relationship Between Executive Function,Serum Prolactin and Thyroid Function in Patients with Bipolar Disorder

目的 研究双相情感障碍患者执行功能与血清催乳素(PRL)、甲状腺功能之间的关系。方法 选取医院2022年2月至2023年2月收治的120例双相情感障碍患者,其中双相情感障碍Ⅱ型抑郁发作患者纳入A组(60例),双相情感障碍Ⅰ型躁狂为主患者纳入B组(60例),以同期医院体检的健康者作为对照组(60例)。A组、B组患者均接受药物治疗,3组均检测相关血清学指标,并评估执行能力、抑郁程度与躁狂程度。结果 较治疗前,A组PRL、促甲状腺激素(TSH)降低,游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))升高(P<0.05);较治疗前,B组PRL、FT_(4)、FT_(3)均降低,TSH升高(P<0.05)。治疗后A组与B组PRL、TSH、FT_(4)、FT_(3)较对照组差异无统计学意义(P>0.05)。较治疗前,A组、B组的正确应答数(RC)、完成分类数(CC)增加,错误应答数(RE)、持续性错误数(RPE)、非持续性错误数(NRPE)减少(P<0.05);治疗后A组与B组RC、CC、RE、RPE、NRPE较对照组差异无统计学意义(P>0.05)。A组治疗后汉密尔顿抑郁量表24项版(HAMD-24)评分低于治疗前(P<0.001)。B组治疗后贝克-拉范森躁狂量表(BRMS)评分低于治疗前(P<0.001)。PRL、TSH水平及WCST的RE、RPE、NRPE与A组HAMD-24评分呈正相关,FT_(3)、FT_(4)水平及WCST的RC、CC与其呈负相关(P<0.05);PRL、FT_(3)、FT_4及WCST的RE、RPE、NRPE与B组BRMS评分呈正相关,TSH水平及WCST的RC、CC与其呈负相关(P<0.05)。结论 双相障碍患者治疗前后血清PRL、甲状腺功能指标水平与执行功能变化明显,且与临床症状评分相关。

Objective To investigate the relationship between executive function,serum prolactin(PRL),and thyroid function in patients with bipolar disorder.Methods A total of 120 patients with bipolar disorder admitted to the hospital from February 2022 to February 2023 were selected.Among them,patients with depressive episodes were included in group A(60 cases),patients with manic episodes were included in group B(60 cases),and healthy individuals who underwent physical examination at the same hospital were used as the control group(60 cases).Both group A and group B patients received medication treatment,and all three groups were tested for relevant serological indicators and evaluated for executive ability,depression level and manic level.Results Compared with before treatment,PRL and thyroid stimulating hormone(TSH)in group A decreased,while free thyroxine(FT 4)and free trnodothyronine(FT 3)increased(P<0.05).Compared to before treatment,PRL,FT 4 and FT 3 in Group B decreased,while TSH increased(P<0.05).After treatment,there was no statistically significant difference in PRL,TSH,FT 4 and FT 3 in group A and group B compared to the control group(P>0.05).Compared with before treatment,the correct response(RC)and completed classification(CC)in groups A and B increased,while the error response(RE),persistent errors(RPE),and non-persistent errors(NRPE)decreased(P<0.05).After treatment,there was no statistically significant difference in RC,CC,RE,RPE,NRPE in group A and group B compared to the control group(P>0.05).After treatment,the 24 item version of the Hamilton depression scale-24(HAMD-24)score in group A was lower than before treatment(P<0.001).After treatment,the Bech-Rafaelsdn mania rating scale(BRMS)score in group B was lower than before treatment(P<0.001).The levels of PRL,TSH,RE,RPE,NRPE of WCST were positively correlated with the HAMD-24 score of group A,while the levels of FT 3,FT 4,RC,CC of WCST were negatively correlated with them(P<0.05).The RE,RPE,NRPE of PRL,FT 3,FT 4 and WCST were positively correlated with the BRMS score of group B,while TSH levels and RC,CC of WCST were negatively correlated with them(P<0.05).Conclusion Here were significant changes in serum PRL,thyroid function indicators,and executive function before and after treatment in patients with bipolar disorder,and they were correlated with clinical symptom scores.