焦虑与抑郁障碍共病患者症状与血清甲状腺激素水平的相关分析

摘要

Objective To explore the correlation between the levels of thyroid hormones and thyroid stimulating hormone (TSH)in clinical symptomsof patients with co - morbid anxiety and depression and to provide a theoretical basis for the treatment of comorbid anxiety and depression. Methods A total of 50 patients with co - morbid anxiety and depression from Sichuan Provincial People′s Hospital Psychosomatic Medicine Center from January 2014 to June 2015 were included. All patients met the standard of Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM - IV)and were first hospitalization. The serum levels of total triiodothyronine( TT3 ),total thyroxine( TT4 ),free triiodothyronine( FT3 ),free thyroxine( FT4 )and TSH were tested by chemiluminescence(CL)analysis. Meanwhile,Self - rating Anxiety Scale(SAS),Self - rating Depression Scale(SDS)and Self -reporting Inventory(SCL - 90)were used to assess all patients. Results For patients with co - morbid anxiety and depression,there was a negative correlation between somatization item and TT4 level;additional item was significantly negatively correlated with FT4 level. Conclusion The levels of thyroid hormones are correlated with clinical symptoms inpatients with co - morbid anxiety and depression. The abnormal levels of thyroid hormone may be one of the causes of the somatic symptoms,insomnia and dietary problems in patients with co - morbid anxiety and depression.%目的：探讨焦虑与抑郁障碍共病患者症状与血清甲状腺激素及促甲状腺激素（ TSH）水平的相关性，为焦虑与抑郁障碍共病的治疗提供理论依据。方法采用单纯随机抽样法，于2014年1月-2015年6月在四川省人民医院心身医学中心抽取50例符合《美国精神障碍诊断与统计手册（第4版）》（DSM -Ⅳ）中焦虑与抑郁障碍共病诊断标准的首次住院患者为研究对象。采用化学发光分析法检测患者血清总三碘甲状腺原氨酸（ TT3）、总甲状腺素（ TT4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）水平，并对患者进行焦虑自评量表（SAS）、抑郁自评量表（SDS）及症状自评量表（SCL -90）评定。结果焦虑抑郁障碍共病患者的甲状腺激素各项及 TSH 水平与 SAS、SDS 评分均无相关性（P 均>0.05）；TT4水平与 SCL -90的躯体化因子评分呈负相关；FT4水平与 SCL -90中的其他因子评分呈负相关。结论焦虑与抑郁障碍共病患者的症状水平与血清甲状腺激素水平有一定的相关性。甲状腺激素水平的异常与焦虑抑郁障碍共病患者躯体化症状、睡眠及饮食问题的产生有一定的关系。