CAJ | 학술논문

目的：探讨血清甲状腺激素水平与抑郁障碍的相关性。方法选取149例单相抑郁障碍患者（单相抑郁障碍组）、40例双相抑郁障碍患者（双相抑郁障碍组）和40名健康者（对照组）为研究对象，检测血清三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离四碘甲状腺原氨酸（FT4）等血清甲状腺激素水平指标。再对单相抑郁组进行3个月治疗随访，根据汉密尔顿抑郁量表（ HMAD）评分结果将其分为临床缓解单相组和临床未缓解单相组，再进行血清甲状腺激素水平和HMAD评分。结果单相抑郁障碍组和双相抑郁障碍组的TSH水平均高于对照组（P＜0．05）。治疗前临床缓解单相组的TSH高于对照组（P＜0．05）。治疗后临床缓解单相组的TSH高于对照组（P＜0．05），而FT3、FT4低于对照组（P＜0．05）。临床缓解单相组治疗后TT3高于治疗前（P＜0．05），而TT4、FT4则显著低于治疗前（P＜0．05）。治疗前、后，临床未缓解单相组的TSH均高于对照组（P＜0．05）。临床未缓解单相组治疗后TSH低于治疗前（ P＜0．05）。治疗前临床缓解单相组的FT3低于临床未缓解单相组（ P＜0．05）。治疗后临床缓解单相组的TT4、FT3低于临床未缓解单相组（P＜0．05）。结论抑郁障碍患者存在甲状腺激素水平的异常，其症状改善与甲状腺激素水平变化有一定关系。
목적：탐토혈청갑상선격소수평여억욱장애적상관성。방법선취149례단상억욱장애환자（단상억욱장애조）、40례쌍상억욱장애환자（쌍상억욱장애조）화40명건강자（대조조）위연구대상，검측혈청삼전갑상선원안산（TT3）、총갑상선소（TT4）、촉갑상선격소（TSH）、유리삼전갑상선원안산（FT3）、유리사전갑상선원안산（FT4）등혈청갑상선격소수평지표。재대단상억욱조진행3개월치료수방，근거한밀이돈억욱량표（ HMAD）평분결과장기분위림상완해단상조화림상미완해단상조，재진행혈청갑상선격소수평화HMAD평분。결과단상억욱장애조화쌍상억욱장애조적TSH수평균고우대조조（P＜0．05）。치료전림상완해단상조적TSH고우대조조（P＜0．05）。치료후림상완해단상조적TSH고우대조조（P＜0．05），이FT3、FT4저우대조조（P＜0．05）。림상완해단상조치료후TT3고우치료전（P＜0．05），이TT4、FT4칙현저저우치료전（P＜0．05）。치료전、후，림상미완해단상조적TSH균고우대조조（P＜0．05）。림상미완해단상조치료후TSH저우치료전（ P＜0．05）。치료전림상완해단상조적FT3저우림상미완해단상조（ P＜0．05）。치료후림상완해단상조적TT4、FT3저우림상미완해단상조（P＜0．05）。결론억욱장애환자존재갑상선격소수평적이상，기증상개선여갑상선격소수평변화유일정관계。
Objective To explore the correlation between the serum thyroxin and depressive symptoms of patients with depression.Methods A total of 149 patients with unipolar depression ( UD group) , 40 patients with bipolar depression ( BD group) and 40 healthy people(control group) were selected and examined for the serum levels of TT3, TT4, TSH, FT3 and FT4.The patients in UD group were treated with antidepressants for 3 months and divided into the remission UD group and the unremission UD group according to the scores of HAMD.The patients in UD group were examined for the HAMD and the serum levels of TT3, TT4, TSH, FT3 and FT4 before and after treatment.Results The serum levels of TSH in UD group and BD group were all significantly higher than those in control group ( P<0.05 ) .Before treatment, the serum level of TSH in the remission UD group was significantly higher than that in control group (P<0.05).After treatment, the serum levels of TSH in the remission UD group were significantly higher and FT3, FT4 significantly lower than those in control group (P<0.05).The serum levels of TT3 in the remission UD group after treatment were significantly higher and TT4, FT4 significantly lower than those before treatment (P<0.05).Before and after treatment, the serum levels of TSH in the unremission UD group were all significantly higher than those in control group (P<0.05).The serum levels of TSH in the unremission UD group after treatment were significantly lower than those before treatment (P<0.05).Before treatment, the serum level of FT3 in the remission UD group was significantly lower than that in the unremission UD group(P<0.05).After treatment, the serum levels of TT4, FT3 in the remission UD group were significantly lower than those in the unremission UD group(P<0.05).Conclusion There is the abnormal level of serum thyroxin in patients with depression and the correlation between the change of serum thyroxin and improvement of symptoms in patients with depression.