T3、FT3、T4、FT4、TSH、TGAb、TPOAb检测在评估精神性疾病患者甲状腺功能中的应用

Combined detection of T3/FT3,T4/FT4,TSH,TGAb and TPOAb for thyroid function in psychosis patients

目的了解三碘甲状腺原氨酸(T3)、游离T3(FT3)、甲状腺素(T4)、游离T4(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)在精神性疾病患者甲状腺功能评估中的应用。方法对106例精神分裂症(精神分裂症组)、77例抑郁症(抑郁症组)、47例双相情感障碍患者(双相情感障碍组)及77例健康体检者(对照组)进行T3、FT3、T4、FT4、TSH、TGAb及TPOAb检测,采用受试者工作特征(ROC)曲线分析各项指标检测的敏感度和特异度。结果精神分裂症组TSH、FT4、TGAb、TPOAb水平高于对照组(P<0.05);抑郁症组TSH和T3水平低于对照组,而FT4、TGAb、TPOAb水平高于对照组(P<0.01);双相情感障碍组T3和T4水平低于对照组,而TSH、TGAb、TPOAb水平高于对照组(P<0.01或0.05)。多项指标联合可明显提高甲状腺功能诊断效能,以7项联合指标诊断效能最高,AUC均≥0.87。结论T3、FT3、T4、FT4、TSH联合TGAb、TPOAb检测可用于评估精神性疾病患者的甲状腺功能。

Objective To study the combined detection of T3/FT3,T4/FT4,thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)for evaluating thyroid function in psychiatric disorders.Methods Serum T3/FT3,T4/FT4,TSH,TGAb and TPOAb levels were determined in 106 schizophrenia,77 depression and 47 bipolar disorder patients and 77 healthy controls.The detection sensitivity and specificity of each parameter were assessed using receiver-operating characteristic(ROC)curve.Results FT4,TSH,TGAb,and TPOAb levels were higher in schizophrenia group than in control group(P<0.05).Compared with control group,T3 and TSH levels were lower,while FT4,TGAb and TPOAb levels were higher in depression group(P<0.01);T3 and T4 levels were lower,whereas TSH,TGAb and TPOAb levels were higher in bipolar disorder group(P<0.01 or 0.05).Combined detection of multiple parameters could significantly improve the diagnostic efficiency,with AUC≥0.87 of each parameter and the highest efficiency of combined seven indexes.Conclusion Combined detection of T3,FT3,T4,FT4,TSH,TGAb and TPOAb could be useful for assessing thyroid function in patients with psychiatric disorders.