双相情感障碍患者甲状腺、肾上腺内分泌代谢与冲动控制、外显行为攻击的关系分析及早期检测价值探讨

Analysis of the relationship between thyroid and adrenal endocrine metabolism,impulse control,and exotic behavior attack in patients with bipolar disorder and exploration of early detection value

目的:研究双相情感障碍(BD)患者甲状腺、肾上腺内分泌代谢与冲动控制、外显行为攻击的关系,并探讨其早期检测价值。方法:回顾性纳入98例BD首发患者作为观察组,根据有、无冲动攻击行为分为有冲动攻击行为组(n=43)和无冲动攻击行为组(n=55)。检测所有受试者甲状腺、肾上腺内分泌代谢水平,采用Spearman相关性分析BD患者内分泌代谢与冲动攻击行为的相关关系。结果:观察组皮质醇(Cor),三碘甲状腺原氨酸(FT3),促甲状腺激素(TSH)均高于对照组,促肾上腺皮质激素(ACTH),甲状腺素(T4)均显著低于对照组(P均<0.05)。有冲动攻击行为组Cor、FT3、TSH均显著高于无冲动攻击行为组,ACTH、T4均显著低于无冲动攻击行为组(P均<0.05)。Cor、ACTH、FT3、TSH、T4表达异常均是BD患者发生冲动攻击行为的影响因素。结论:甲状腺、肾上腺内分泌代谢异常是BD患者冲动外显,产生攻击行为的影响因素,其与BD攻击行为具有相关性,可能具有早期检测价值。

Objective:To study the relationship between thyroid and adrenal endocrine metabolism,im-pulse control,and overt behavioral aggression in patients with bipolar disorder(BD),and to explore its early de-tection value.Method:A total of 98 first-time BD patients were retrospectively selected as the observation group.They were divided into impulsive aggressive behavior group(n=43)and non impulsive aggressive be-havior group(n=55)based on their presence and absence of impulsive aggressive behavior.Detect the levels of thyroid and adrenal endocrine metabolism in all subjects,and use Spearman correlation analysis to examine the correlation between endocrine metabolism and impulsive aggressive behavior in BD patients.Results:Cortisol(Cor),triiodothyronine(FT3),and thyroid stimulating hormone(TSH)in the observation group were all higher than those in the control group,while adrenocorticotropic hormone(ACTH)and thyroid hormone(T4)were significantly lower than those in the control group(all P<0.05).The Cor,FT3,and TSH of the impulsive ag-gressive behavior group were significantly higher than those of the non impulsive aggressive behavior group,while ACTH and T4 were significantly lower than those of the non impulsive aggressive behavior group(all P<0.05).Abnormal expression of Cor,ACTH,FT3,TSH,and T4 are all influencing factors for impulsive aggressive behavior in BD patients.Conclusion:Abnormalities in thyroid and adrenal endocrine metabolism are influen-cing factors for impulsive overtones and aggressive behavior in BD patients,and they are correlated with BD ag-gressive behavior,which may have early detection value.