合并亚临床甲状腺功能减退老年抑郁症住院患者的临床特征分析

Clinical Characteristics Analysis of Hospitalized Elderly Depression Patients with Subclinical Hypothyroidism

背景老年抑郁症是一种有别于其他年龄阶段抑郁症的严重精神疾病,具有明显的异质性。亚临床甲状腺功能减退(SCH)是一种临床体征不明显的甲状腺功能减退状态,而SCH对老年抑郁症的影响容易被人们忽视,目前对SCH和老年抑郁症的关联研究较少。目的探讨合并SCH老年抑郁症住院患者的临床特征。方法纳入2019年4月—2023年3月合肥市第四人民医院住院治疗的抑郁症患者为研究对象,将患者分为亚临床甲状腺功能减退抑郁症(SCHD)组(108例)与抑郁症对照(CD)组(110例)。收集研究对象的一般资料,采集空腹静脉血样本检测生化指标,采用汉密尔顿抑郁量表(HAMD-24)评估患者抑郁症状。结果SCHD组患者使用抗精神病药物例数、躯体疾病数、住院治疗天数、病程多于CD组(P<0.05),两组患者使用抗抑郁药物种类、住院治疗次数比较,差异有统计学意义(P<0.05)。HAMD-24评分结果显示,SCHD组患者睡眠障碍评分高于CD组(P<0.05),两组患者体质量、日夜变化评分比较,差异有统计学意义(P<0.05)。SCHD组促甲状腺激素水平高于CD组,血清游离三碘甲状腺原氨酸、血清游离甲状腺素水平低于CD组(P<0.05)。结论合并SCH的老年抑郁症患者临床特征特殊,住院治疗时间更长,病情发作更频繁,较难治愈,针对SCH的干预是非常必要的。

Background Geriatric depression is a severe mental illness distinct from depression in other age groups,characterized by significant heterogeneity.Subclinical hypothyroidism(SCH)is a state of hypothyroidism with subtle clinical signs.The impact of SCH on elderly depression is easily overlooked,and the association between SCH and elderly depression is not well understood.Objective To explore the clinical characteristics of hospitalized elderly depression patients with SCH.Methods Depressed patients hospitalized in the Fourth People's Hospital of Hefei from April 2019 to March 2023 were included in the study and divided into the subclinical hypothyroidism depression(SCHD)group(n=108)and control depression(CD)group(n=110).General data of the subjects was collected,fasting venous blood samples were collected for testing biochemical markers,and the Hamilton Depression Rating Scale(HAMD-24)was used to assess depressive symptoms.Results The SCHD group showed a higher number of antipsychotic drug use,comorbid somatic diseases,days of hospitalization,and duration of the disease than the CD group(P<0.05).There was a statistically significant difference between the two groups in terms of the types of antidepressants used and the number of hospitalizations(P<0.05).The sleep disorder scores of patients in the SCHD group were higher than those in the CD group(P<0.05),and there was a significant difference in body mass and diurnal variation scores between the two groups(P<0.05).The SCHD group had higher levels of thyrotropin and lower levels of serum free triiodothyronine and free thyroxine than the CD group(P<0.05).Conclusion Elderly depression patients with SCH exhibit unique clinical characteristics,including longer hospitalization,more frequent episodes,greater difficulty to cure,and poorer prognosis,making interventions for SCH essential.