不同年龄组男性抑郁障碍患者炎性反应、甲状腺功能、性激素水平和皮质醇指标的变化

Study on inflammatory response,thyroid function,sex hormones and cortisol in male patients with depressive disorder in different age

目的 研究不同年龄阶段男性抑郁障碍患者炎性反应、甲状腺功能、性激素、皮质醇相关指标水平的变化及其相关性,探讨更为个性化的治疗方案。方法 选取2022年1月~2022年10月于开滦精神卫生中心住院的男性中重度抑郁障碍患者166例,分为青年组、中年组、老年组。收集患者的一般资料、白细胞计数、淋巴细胞计数;甲状腺素、三碘甲状原氨酸(triiodothyronine,T3)、促甲状腺激素、游离T3、游离四碘甲状原氨酸数值;睾酮、泌乳素、雌二醇水平;促肾上腺皮质激素和皮质醇水平进行数据分析。结果 患者的年龄与白细胞计数、淋巴细胞计数、游离T3、促甲状腺激素水平成负相关,与皮质醇水平成正相关。典型相关结果为性激素相关指标与皮质醇相关指标的相关性最显著,典型相关系数平方为0.40。结论 男性中重度抑郁障碍患者白细胞计数、淋巴细胞计数、游离T3、促甲状腺激素水平与年龄呈负相关,且下丘脑-垂体-肾上腺素轴更易出现功能紊乱。下丘脑-垂体-性腺/肾上腺素轴之间可能起到正向协调作用。

Objective To investigate the changes of inflammatory response,thyroid function,sex hormones and cortisol in male patients with depressive disorder at different ages and their correlations,and to explore more personalized treatment plans.Methods A total of 166 male patients with moderate to severe depressive disorder,hospitalized in Kailuan Mental Health Center from January 2022 to October 2022 were selected.They were divided into the young,the middle-aged and the elderly groups.The general data,inflammatory response,thyroid function,sex hormones and cortisol levels of the patients were collected.Results The age of patients was negatively correlated with White blood cell(WBC)count,Lymphocyte count,Free triiodothyronine(FT3)level and Thyroid stimulating hormone(TSH)level,and positively correlated with Cortisol level.The canonical correlation results showed that the correlation between sex hormone related indexes and cortisol related indexes was the most significant,and the canonical correlation coefficient square was 0.40.Conclusion With the increase of age,WBC count,lymphocyte count,FT3 and TSH levels in male patients with moderate and severe depressive disorder show a downward trend,and hypothalamic-pituitary-epinephrine axis is more likely to have dysfunction.The hypothalamic-pituitary-gonadal/epinephrine axis may play a positive coordination role.