抑郁症患者血清甲状腺激素水平变异分析

目的　了解血清甲状腺激素水平与抑郁症的关系。方法　对 6 4例门诊及住院抑郁症患者中双相抑郁障碍 34例、单相抑郁障碍 30例治疗前后血清三碘甲状腺原氨酸 (T3 )、甲状腺素 (T4)和促甲状腺激素 (TSH)进行检测 ,同时以30名健康志愿者作为对照组。治疗前后应用汉密尔顿抑郁量表 (HAMD)和Montgomery Asbery抑郁量表 (MADRS) ,评定抑郁症状的严重程度。结果　患者组治疗前后T3 (1.98± 0 .5 2 )nmol·L-1,(1.90± 0 .5 8)nmol·L-1]均明显高于对照组 (1.5 8± 0 .2 7)nmol·L-1],单相抑郁障碍患者治疗后T4(93.4 1± 2 9.4 1)nmol·L-1]低于治疗前 (10 4± 2 0 .2 4 )nmol·L-1],并恢复到正常范围 ,HAMD和MADRS评分也随之明显下降。结论　提示抑郁症患者甲状腺激素水平改变与症状的消失有关 ,甲状腺激素异常是继发于情绪障碍 ,双相抑郁障碍与单相抑郁障碍在病因学方面可能不同。

Thyroid hormones abnormalities in patients with depression

Objective To examine the relati on ship between serum thyroid hormones level and depression. Methods Serum triiodothyronine (T 3), thyroxin (T 4), thyrotropin (TSH) were me asured in 64 inpatients and outpatients with depression, 34 with bipolar depress ion (BD) and 30 with unipolar depression (UD), before and after treatment. Hamil ton Depression Scale (HAMD) and Montgomery-Asberg Depression Rating Scale (MADR S) were used to assess the depressive symptoms before and after treatment. Results Serum T 3 was higher in patients group before and a fter treatment than in 30 normal controls. Compared with that of controls, T 4 was lower in UD patients after the treatment than before the treatment. Aft er treatment, these parameters returned to normal range with the improvement ass essed by the scores of HAMD and MADRS. Conclusion Serum thyroid hormones are associated with the changes of symptoms in patients w ith depression. There may be difference in etiology between bipolar depression a nd unipolar depression.