摘要
目的:探讨难治性失眠症血清甲状腺激素水平变化与抑郁情绪的关系。方法:选取2019年10月—2022年10月南阳市第四人民医院收治的151例难治性失眠症患者作为研究组,另选取同期到院体检的151名健康体检者作为对照组。两组受试者均进行血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)水平检测。根据心理评估结果将难治性失眠患者分为抑郁组[42例,汉密尔顿抑郁量表(HAMD)总分≥8分]与无抑郁组(109例,HAMD总分<8分),对比其血清甲状腺激素水平。采用Pearson相关系数分析难治性失眠症患者血清甲状腺激素水平与HAMD评分的相关性,采用logistic回归分析患者并发抑郁情绪的影响因素。结果:研究组患者血清T3、T4、FT3、FT4水平均低于对照组,差异均有统计学意义(t=12.054、8.892、4.547、10.411,P<0.05);抑郁组患者血清FT3水平低于无抑郁组,差异有统计学意义(t=3.020,P<0.05);经Pearson相关性分析,难治性失眠症患者血清T3、T4、FT4水平均与HAMD总分无相关性(r=0.316、0.304、0.285,P>0.05),FT3水平与HAMD总分呈负相关(r=-0.738,P<0.001);logistic回归分析结果显示,病程、匹兹堡睡眠质量指数(PSQI)评分是难治性失眠症患者并发抑郁情绪的危险因素(OR=3.838、4.170,P<0.05),血清FT3水平是保护因素(OR=0.572,P<0.05),结论:难治性失眠症患者血清T3、T4、FT3、FT4水平均明显降低,且FT3水平低表达可增加患者并发抑郁情绪的风险。
Objective:To explore the change of serum thyroid hormone level in patients with refractory insomnia and its relationship with depression.Methods:151 patients with refractory insomnia admitted to the hospital were selected as the study subjects and 151 health examinees in the same period were set as the control group.The levels of serum triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3)and free tetraiodothyronine(FT4)were detected in both groups.In addition,the patients were divided into depression group[total score of Hamilton Depression Scale(HAMD)≥8 points]and non depression group(total score of HAMD<8 points)according to the psychological evaluation results,and the serum thyroid hormone levels were compared.The correlation between serum thyroid hormone level and HAMD score in patients with refractory insomnia was analyzed by Pearson correlation coefficient,and the influencing factors of depression in patients was analyzed by multivariate logistic regression method.Results:The levels of serum T3,T4,FT3 and FT4 in the study group were lower than those of the control group(t=12.054,8.892,4.547,10.411;P<0.05).And the serum FT3 level was lower than that in the non depression group(t=3.020,P<0.05).The serum T3,T4 and FT4 levels in patients with refractory insomnia were not correlated with the total score of HAMD(r=0.316,0.304,0.285;P>0.05),while the serum FT3 level was negatively correlated with the total score of HAMD(r=-0.738,P<0.001).The course of disease and Pittsburgh Sleep Quality Index(PSQI)score were risk factors for depression in patients with refractory insomnia(OR=3.838,4.170;P<0.05),while the serum FT3 level was a protective factor for it(OR=0.572,P<0.05).Conclusion:The levels of serum T3,T4,FT3 and FT4 in patients with refractory insomnia are significantly reduced,and low expression of FT3 level can increase the risk of depression in patients.
作者
李冰
徐子娇
Li Bing;Xu Zijiao(Seventh Department of Psychiatry,The Fourth People’s Hospital of Nanyang City,Nanyang,Henan,473000,China)
出处
《黑龙江医学》
2024年第16期1940-1942,共3页
Heilongjiang Medical Journal
