不同性别双相情感障碍患者的临床特点及甲状腺功能变化趋势分析

Analysis of Clinical Characteristics and Thyroid Function Change Trend in Patients with Bipolar Disorders of Different Genders

目的:分析不同性别双相情感障碍患者的临床特点及甲状腺功能变化趋势。方法:回顾江西省精神病院精神科2021年1月—2023年5月收治的80例双相情感障碍患者资料,其中男49例,女31例。比较不同性别患者基线资料、临床特点及治疗前后甲状腺功能,使用Pearson相关系数及Spearman相关系数分析相关性。结果:不同性别患者年龄、发病年龄、文化水平、病程、家族史、伴精神病性症状、心境稳定剂使用比较,差异均无统计学意义(P>0.05);女性患者以抑郁为首发症状占比、使用抗抑郁药物占比均高于男性患者,住院时间长于男性患者,差异均有统计学意义(P<0.05)。不同性别患者出院前1 d较入院第1天的总三碘甲状腺原氨酸(TT_(3))、游离三碘甲状腺原氨酸(FT_(3))、总甲状腺素(TT_(4))、游离甲状腺素(FT_(4))均下降,促甲状腺激素(TSH)均上升,差异均有统计学意义(P<0.05),女性患者FT_(4)、TT_(4)差值均大于男性患者,差异均有统计学意义(P<0.05)。男性患者TT_(4)、FT_(4)、FT_(3)差值与伴精神病性症状均呈正相关(P<0.05);女性患者FT_(4)、FT_(3)差值与伴精神病性症状呈负相关(P<0.05),女性患者FT_(4)、FT_(3)差值与抗抑郁药物使用、首发症状呈正相关(P<0.05)。结论:不同性别双相情感障碍患者的临床特点及甲状腺功能变化存在差异,其中女性患者治疗后甲状腺功能下降更明显,与伴精神病性症状、抗抑郁药物使用、首发症状相关。

Objective:To analyze the clinical characteristics and the change trend of thyroid function in patients with bipolar disorders of different genders.Method:The data of 80 patients with bipolar disorders admitted to Department of Psychiatry of Jiangxi Mental Hospital were reviewed from January 2021 to May 2023,including 49 males and 31 females.The baseline data,clinical characteristics and thyroid function before and after treatment were compared between different genders.Pearson correlation coefficient and Spearman correlation coefficient were used to analyze the correlation.Result:There were no statistically differences in age,age of onset,education level,disease course,family history,psychotic symptoms and mood stabilizer use among patients with different genders(P>0.05);the proportion of depression as the first symptom and the proportion of using antidepressant of female patients were higher than those of male patients,and the hospital stay was longer than that of male patients,the differences were statistically significant(P<0.05).The levels of total triiodothyronine(TT_(3)),free triiodothyronine(FT_(3)),total thyroxine(TT_(4))and free thyroxine(FT_(4))in patients with different genders were decreased at 1 day before discharge compared with those at 1 day after admission,while the levels of thyroid-stimulating hormone(TSH)were increased,the differences were statistically significant(P<0.05),and the differences of FT_(4)and TT_(4)in female patients were greater than those in male patients,the differences were statistically significant(P<0.05).The differences of TT_(4),FT_(4)and FT_(3)in male patients were positively correlated with psychotic symptoms(P<0.05);and the differences of FT_(4)and FT_(3)in female patients were negatively correlated with psychotic symptoms(P<0.05),and the differences of FT_(4)and FT_(3)in female patients were positively correlated with antidepressant use and first symptoms(P<0.05).Conclusion:There are differences in the clinical characteristics and thyroid function in patients bipolar disorders of different genders,among which the thyroid function decline is more obvious in female patients after treatment,which is associated with psychotic symptoms,antidepressant use and first symptoms.