难治性抑郁症的临床特征以及甲状腺激素水平的对照研究

摘要

目的：探讨难治性抑郁症的临床特征以及甲状腺激素水平。方法采用汉密尔顿抑郁量表17项版（HRSD-17）和汉密尔顿焦虑量表（HAMA）对符合《国际疾病分类（第10版）》（ICD-10）诊断标准的48例难治性抑郁症患者和54例非难治性抑郁症患者进行测评，采用放射免疫法测定两组患者血清促甲状腺激素（ TSH）、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）水平。结果难治性抑郁症组（TRD组）与非难治性抑郁症组（非TRD组）比较，起病年龄更早[（16.4±3.8）岁vs.（23.6±4.3）岁]，受教育年限更短[（8.7±2.1）年vs.（10.6±2.3）年]，本次发病病程更长[（65.1±18.3）月vs.（4.9±2.5）月]，HRSD-17中行为阻滞因子评分更高[（8.37±2.43）分vs.（6.51±2.55）分]，血清FT3水平更低[（3.93±0.52）pmol/L vs.（4.21±0.49）pmol/L]，差异均有统计学意义（ P﹤0.05）。结论难治性抑郁症患者单次病程长，起病早，文化水平低，阻滞症状重，血清FT3水平低。%Objective To explore the clinical characteristics and thyroid hormone levels of treatment - resistant depression ( TRD). Methods 48 patients with TRD and 54 patients with non-TRD in accord with International Classification of Diseases,tenth edition(ICD-10)diagnostic criteria were assessed with Hamilton Rating Scale for Depression-17 item(HRSD-17)and Hamilton Anxiety Rating Scale( HAMA). All research objects were measured for serum thyroid-stimulating hormone( TSH),total triodothgro-nine( TT3 ),total thyroxine( TT4 ),free triodothgronine( FT3 )and free thyroxine( FT4 )by radioimmunoassay. Results Compared with patients with non treatment-resistant depression(23. 6 ± 4. 3)years,the patients with treatment-resistant depression(16. 4 ± 3. 8)years have younger first onset age. the patients with treatment-resistant depression(8. 7 ± 2. 1)years have lower education level than non treatment-resistant depression(10. 6 ± 2. 3)years. The patients with treatment-resistant depression(65. 1 ± 18. 3)months have longer course of disease than non treatment-resistant depression(4. 9 ± 2. 5)months. Behavior retarding factor in HRSD-17 were higher in the patients with treatment -resistant depression(8. 37 ± 2. 43)than non treatment -resistant depression(6. 51 ± 2. 55). The free triodothgronine of the patients with treatment-resistant depression(3. 93 ± 0. 52)pmol/L were lower than non treat-ment-resistant depression(4. 21 ± 0. 49)pmol/L. The differences were statistical significance between the two groups(P﹤0. 05). Conclusion The patients with treatment-resistant depression have long course of disease,young first onset age,low education level, severe retardation symptoms,and low serum free triodothgronine level.