双相情感障碍与甲状腺激素水平变化之间的关系

Relationship between bipolar affective disorder and thyroid hormone levels

目的分析双相情感障碍的临床特征,探讨疾病与血清甲状腺激素水平之间的关系。方法随机抽取2020年1月至2022年2月在泉州第三医院和福州神经精神病防治院诊治的双相情感障碍患者67例,将其中31例抑郁发作患者分为抑郁组,36例躁狂发作患者分为躁狂组,同时随机选取健康体检者35例分为对照组,比较3组研究对象的血清甲状腺激素水平[包括甲状腺激素(TSH)、血清三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺激素(FT_(4))水平],并采用蒙哥马利抑郁评定量表(Montgomery depression rating scale,MADRS)对抑郁组和躁狂组患者的抑郁情绪进行评估,采用杨氏躁狂评定量表(Young mania rating scale,YMRS)对抑郁组和躁狂组患者的躁狂情绪进行评估,分析双相情感障碍患者血清甲状腺激素水平与MADRS、YMRS总评分的相关性。结果3组研究对象的T_(4)及FT_(4)水平比较,差异均无统计学意义(均P>0.05);抑郁组的TSH水平低于躁狂组及对照组,差异均有统计学意义(均P<0.05);抑郁组及躁狂组患者的FT_(3)水平均低于对照组(均P<0.05),而抑郁组与躁狂组的FT_(3)水平比较差异无统计学意义(P>0.05);抑郁组的T_(3)水平低于躁狂组和对照组(均P<0.05),而躁狂组与对照组的T_(3)水平比较差异无统计学意义(P>0.05)。相关性分析结果显示,抑郁组患者的甲状腺激素水平与MARDS、YMRS总评分无显著相关性(P>0.05),躁狂发作患者的甲状腺激素水平与YMRS评分无显著相关性(P>0.05)。结论双相情感障碍患者存在甲状腺功能紊乱现象,甲状腺功能衰退风险较高;甲状腺激素与双相情感障碍无明显相关系,但可作为临床用药参考指标。

Objective To analyze the clinical features of bipolar disorder and to explore the relationship between the disease and serum thyroid hormone levels.Methods 67 patients with bipolar disorder were randomly selected from Quanzhou Third Hospital and Fuzhou Neuropsychiatric Hospital from January 2020 to February 2002.Among the selected patients,there were 31 depressive authors and 36 manic authors and they were classified into the manic group,and 35 healthy subjects were randomly selected as control subjects and included into the control group,the levels of serum thyroid hormones,including thyroid hormone(TSH),serum triiodothyronine(T_(3)),thyroid hormone(T_(4)),free triiodothyronine(FT_(3)),and free thyroid hormone(FT_(4)),were measured in all three groups(depression group,manic group,and control group),the depressive mood of patients in the depression group and manic group was evaluated by the Montgomery Depression Rating Scale(MADRS)and the scores of patients in the two groups were compared.The manic mood of patients in the depression group and manic group was evaluated by the young mania rating scale(YMRS)and the scores of patients in the two groups were compared.Compare the thyroid hormone level of the three groups of subjects,analyze the correlation between the serum thyroid hormone level of patients with bipolar affective disorder and the total score of MADRS,and analyze the correlation between the serum thyroid hormone level of patients with bipolar affective disorder and the total score of YMRS.Results There was no significant difference in the levels of T_(4)and FT_(4)among the three groups research object(P>0.05).The TSH level in the depression group was lower than that in the mania group and the control group(P<0.05),and the FT_(3)level in the depression group and the mania group was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the level of FT_(3)between groups(P>0.05).The T_(3)level in the depression group was lower than that in the mania group and the control group,and the difference was statistically significant(P<0.05).The results of correlation analysis showed that there was no significant correlation between thyroid hormone levels and MARDS total score and YMRS total score in patients with depressive episodes(P>0.05);There was no significant correlation between Thyroid hormones level and YMRS score in manic episode patients(P>0.05).Conclusion There is thyroid dysfunction in patients with bipolar disorder,and the risk of thyroid dysfunction is high.Thyroid hormones are not significantly related to bipolar disorder,but there may be some hints for clinical medication.