抑郁症复发患者甲状腺功能减退与认知功能障碍的相关性

摘要

目的：探讨抑郁症复发患者甲状腺功能减退与认知功能障碍相关性。方法选取西安市精神卫生中心精神科就诊患者240例，根据抑郁症发作情况分为首发组和复发组，并选择同期健康体检者150例作为对照组。比较认知功能评分、甲状腺激素水平、血清叶酸（FA）水平和同型半胱氨酸（HCY）水平之间的差异性，并分析各因素与认知功能损伤之间的相关性。结果复发组与首发组、对照组相比，各评分均较低，差异有统计学意义（P＜0．05）。进一步研究发现，复发组血清甲状腺素（T4）、血清游离甲状腺素（FT4）水平低于对照组和首发组，促甲状腺激素（TSH）高于对照组和首发组，差异有统计学意义（P＜0．05）。与对照组和首发组相比，复发组 HCY升高，FA水平均下降，差异有统计学意义（P＜0．05）。相关性分析显示，TSH、HCY与简易精神状态量表（MMSE）呈现负相关性，T4、FT4、FA与MMSE呈现正相关性。结论本研究证实了抑郁症复发的患者甲状腺功能的减退与认知功能障碍相关，并分析发现可能通过 HCY水平的升高和FA的下降所导致，为抑郁症复发与认知功能障碍的相关性研究奠定了基础，为临床治疗提供分子靶标。%Objective To analyze the correlation between hypothyroidism and cognitive dysfunction in the pa‐tients with recurrence of depression .Methods 240 patients with depression in the Xi′an Mental Health Center were chosen and divided into the first onset group and relapse group according to the depression onset situation .The differ‐ences in the cognitive function score ,thyroid hormone level ,serum folic acid(FA) and homocysteine(HCY) levels were analyzed ,and the correlation between each factor with the cognitive function impairment were analyzed .Results The various scores of the relapse group were obviously lower than those in the first onset group and the control , the differences were statistically significant (P<0 .05) .The further research found that the serum levels of T4 and FT4 in the relapse group were lower than those in the control group and the first onset group ,while the TSH level was higher ,the differences were statistically significant (P<0 .05) .Moreover ,the serum HCY level was increased and the FA level was decreased in the relapse group compared with the control and the first onset group ,the differ‐ences were statistically significant (P<0 .05) .The correlation analysis indicated that serum levels of TSH and HCY were negatively correlated with MMSE ,while the T4 ,FT4 and FA levels were positively correlated with MMSE . Conclusion This research confirms that hypothyroidism is correlated with the cognitive impairment in the patients with recurrence of depression ,which might be led by rising of HCY level and decreasing of FA level ,thus lays a foun‐dation for the related study of correlation between recurrence of depression with the cognitive function impairment and provides a molecular target for clinical treatment .