焦虑和非焦虑型男性抑郁患者P300和甲状腺激素、性激素水平对比研究

摘要

目的：探讨焦虑和非焦虑型男性抑郁患者 P300特征和甲状腺激素、性激素水平的差异。方法入组95例男性抑郁患者（焦虑型和非焦虑型分别为45和50例），检测患者 P300电位 N1、P2、N2、P3潜伏期和波幅，并测定其血清游离和总三碘甲状腺原氨酸（FT3、T3）、甲状腺素（FT4、T4）以及卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇（E2）、孕酮（PROG）、睾酮（TESTO）和垂体泌乳素（PRL）水平，同时利用 HAMD17评定患者临床症状。结果（1）焦虑型患者 N1、P2、N2和 P3潜伏期延长（t＝2．45，P ＝0．02；t＝3．55，P ＝0．00；t＝2．92，P ＝0．00；t＝2．62，P ＝0．01）。（2）焦虑型患者 P3波幅下降（t ＝－2．52，P ＝0．01）。（3）焦虑型患者 E2和 TESTO 下降（t ＝－2．98，P ＝0．0；t ＝－2．48，P ＝0．01）；而焦虑型患者 T4上升（t＝2．19，P ＝0．03）。（4）患者 P2和 P3潜伏期及 T4均与焦虑因子分呈正相关（r＝0．21，P ＝0．04；r＝0．28，P ＝0．00；r＝0．21，P ＝0．04）；而 E2、TESTO 与焦虑因子分呈负相关（r＝－0．30，P＝0．00；r＝－0．20，P ＝0．05）。结论男性抑郁患者存在认知功能损害和甲状腺激素、性激素水平紊乱，且与其焦虑症状相关。%Objective To compare the differences of P300,thyroid and sex hormone level between male anxious de-pression and nonanxious depression.Methods Enrolled 95 male depressive patients (anxious depression and nonanx-ious depression were 45,50 respectively).The latency and amplitude of N1 ,P2 ,N2 and P3 of all patients were examined with P300.The thyroid and sex hormone level of all patients were measured.The HAMD17 was used to assess the clin-ical symptoms of patients.Results (1)The latency of N1 ,P2 ,N2 and P3 in anxious depression were significantly longer (t=2.45,P =0.02;t=3.55,P =0.00;t=2.92,P =0.00;t=2.62,P =0.01).(2)The amplitude of P3 in anxious de-pression was significantly lower(t=-2.52,P =0.01).(3)The level of E2 and TESTO in anxious depression was sig-nificantly lower(t=-2.98,P =0.00;t=-2.48,P =0.01);however,the level of T4 in anxious depression was signifi-cantly higher(t=2.19,P =0.03).(4)The latency of P2 ,P3 and T4 were positively related with the anxiety factor score (r=0.21,P =0.04;r=0.28,P =0.00;r=0.21,P =0.04),however,the level of E2 and TESTO were negatively relat-ed with the anxiety factor score(r=-0.30,P =0.00;r=-0.20,P =0.05).Conclusion There are obvious impairment of cognitive function,thyroid and sex hormone level in the male depression,which are related to the anxiety of patients.