CAJ | 학술논문

目的：分析单、双相抑郁症患者临床特征及血清甲状腺激素水平的差异。方法采用电化学发光免疫分析法分别测定42例双相障碍抑郁症患者、77例单相抑郁症患者和69名正常对照组健康人的血清三碘甲状腺原氨酸（ T3）、甲状腺素（T4）、游离甲状腺激素（FT3、FT4）和促甲状腺激素（TSH）水平，采用汉密尔顿抑郁量表（HAMD）评估临床症状及抑郁的严重程度，并分析三组间甲状腺功能的差异，以及单相、双相抑郁患者甲状腺素水平与其HAMD各项评分的相关性。结果双相抑郁组患者的起病年龄低于单相抑郁组（P＜0．05），发病前有明显诱因者少于单相抑郁组（P＜0．05）。单相抑郁组和双相抑郁组HAMD总分差异无统计学意义（P＞0．05），单相抑郁组的认知障碍因子分高于双相抑郁组（P＜0．05）。三组间血清T3、T4、TSH水平比较差异无统计学意义（P＞0．05），单相抑郁组的FT3低于双相抑郁组及正常对照组（P＜0．05），双相抑郁组血清FT4高于单相抑郁组及对照组（P＜0．05）。相关分析显示，单相、双相抑郁组血清甲状腺素水平与HAMD总分无相关性（P＞0．05），单相抑郁组血清T4水平与阻滞因子分成正相关（P＜0．05）。结论单相抑郁和双相抑郁患者的临床特征有所不同，单相抑郁症患者可能伴有甲状腺功能减退，血清FT4可能是双相抑郁症的生物学标记。
목적：분석단、쌍상억욱증환자림상특정급혈청갑상선격소수평적차이。방법채용전화학발광면역분석법분별측정42례쌍상장애억욱증환자、77례단상억욱증환자화69명정상대조조건강인적혈청삼전갑상선원안산（ T3）、갑상선소（T4）、유리갑상선격소（FT3、FT4）화촉갑상선격소（TSH）수평，채용한밀이돈억욱량표（HAMD）평고림상증상급억욱적엄중정도，병분석삼조간갑상선공능적차이，이급단상、쌍상억욱환자갑상선소수평여기HAMD각항평분적상관성。결과쌍상억욱조환자적기병년령저우단상억욱조（P＜0．05），발병전유명현유인자소우단상억욱조（P＜0．05）。단상억욱조화쌍상억욱조HAMD총분차이무통계학의의（P＞0．05），단상억욱조적인지장애인자분고우쌍상억욱조（P＜0．05）。삼조간혈청T3、T4、TSH수평비교차이무통계학의의（P＞0．05），단상억욱조적FT3저우쌍상억욱조급정상대조조（P＜0．05），쌍상억욱조혈청FT4고우단상억욱조급대조조（P＜0．05）。상관분석현시，단상、쌍상억욱조혈청갑상선소수평여HAMD총분무상관성（P＞0．05），단상억욱조혈청T4수평여조체인자분성정상관（P＜0．05）。결론단상억욱화쌍상억욱환자적림상특정유소불동，단상억욱증환자가능반유갑상선공능감퇴，혈청FT4가능시쌍상억욱증적생물학표기。
Objective To explore the differences for clinical characteristics and serum levels of thyroid hormones in patients with unipolar and bipolar depression.Methods A total of 42 patients with bipolar depression in bipolar depression group, 77 patients with unipolar depression in unipolar depression group and 69 health person in control group were included in the study and the serum triodothyronine (T3), thyroxin(T4), free-triiodothyronine(T3), thyroxin(T4) and thyroid stimulating hormone ( TSH) levels of all subjects were measured using electrochemiluminescence immunoassay.The patients with depression were assessed with Hamilton Depression Scale ( HAMD) for the clinical symptoms to explore the differences for serum levels of thyroid hormones between bipolar depression group, unipolar depression group and control group, and the relationship between serum levels of thyroid hormones and depressive symptoms in bipolar depression group and unipolar depression group.Results The age of onset in bipolar depression group was significantly lower than that in unipolar depression group ( P <0.05 ) .There were significantly more premorbid predisposition in unipolar depression group than those in bipolar depression group(P<0.05).There was no significant difference in the total score of HAMD between bipolar depression group and unipolar depression group, and the score of congnition factor on HAMD in uniporlar group was significantly higher than that in bipolar depression(P<0.05).There were no significant differences in serum levels of T3, T4 and TSH between unipolar depression group, bipolar depression group and control group.The levels of FT3 in unipolar depression group were all significantly lower than those in control group and bipolar depression group (P<0.05).The levels of FT4 in bipolar depression group were significantly higher than those in control group and unipolar depression group (P<0.05).The total scores of HAMD were not related to the serum levels of thyroid hormones in unipolar and bipolar depression group, and the retardant factor scores of HAMD were positively related to the serum levels of T4 in unipolar depression patients(P<0.05).Conclusion There are some differences in sclinical characteristics between unipolar and bipolar depression.There may be thyroid disfunction in the patients with unipolar depression and it may be biological marker for the serum level of FT4 in the patients with bipolar depression.