首发抑郁症、复发抑郁症患者血清甲状腺激素和性激素水平变化的对比研究

发布时间：2018-02-02 16:38

本文关键词： 首发抑郁症复发抑郁症性激素甲状腺激素　出处：《郑州大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的探讨首发抑郁症、复发抑郁症患者血清甲状腺激素和性激素水平的变化,了解抑郁症的发病机制并为其临床治疗提供理论依据。方法采用病例对照研究的方法,按照《国际疾病和相关健康问题统计分类第十版》(ICD-10)诊断标准收集HAMD-2420分的118例抑郁症患者(实验组)和HAMD8分的60例健康者(对照组),其中实验组有63例首次抑郁症发作患者、55例病情复发两次及以上患者,将实验组和健康对照组按性别分为男性和女性两个亚组。采用电化学发光免疫分析法测定血清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)、雌激素(E2)、孕酮(P)、睾酮(T)的水平(月经期者于月经干净3天后抽血,以减少激素受月经周期的影响而产生误差)。统计方法采用卡方检验、两样本t检验,β=0.05、P0.05表示差异有统计学意义。结果 1首发、复发组和对照组三组间性激素比较 (1)首发与对照组比较：首发组男性、女性抑郁症患者血清雌二醇水平均显著低于正常对照组(P0.01； P0.01)；首发男性患者的睾酮水平显著低于正常对照组(P=-0.034),而首发女性患者的睾酮水平与正常对照组相比无显著差异(P=0.612)。男、女首发抑郁患者的睾孕酮水平与对照组相比无显著变化(P=0.383、P=0.842)。 (2)复发与对照组比较：复发组男性、女性抑郁症患者血清雌二醇均显著低于正常对照组(P0.01； P0.01)；复发男性患者的睾酮水平显著低于正常对照组(P=0.024),而复发女性患者的睾酮水平与正常对照组相比无显著差异(P=0.542);男、女首发抑郁患者的孕酮水平与对照组相比无显著变化(P=0.132、P=0.319)。 (3)首发与复发抑郁症组比较：复发组男性雌二醇水平较首发组减低,但两组对照无显著差异(P=0.124),而复发组女性雌二醇水平明显低于首发组(P=0.007)；复发组男性睾酮较首发组稍减低,两组间比较无显著差异(p=0.294),复发组女性睾酮水平与首发组相比无显著差异(P=0.730)；男、女首发抑郁症患者孕酮水平与复发组相比差异无显著变化(P=0.378、P=0.626)。 2首发、复发组和对照组甲状腺激素比较 (1)首发与对照组比较：男、女首发组FT3较对照组升高,但无显著差异(P=0.682、P=0.735)；男、女首发组FT4与对照组相比有显著差异(P=0.025、P=0.034)男、女首发组TSH较对照组偏低,但无显著差异(P=0.845、P=0.503)。 (2)复发与对照组比较：男、女复发组FT3与对照组相比有显著差异(P=0.012、P=0.027)；男、女复发组FT4与对照组相比有显著差异(P=0.038、P=0.022)；男、女复发组TSH与对照组相偏低,但无显著差异(P=0.734、P=0.725)。 (3)首发与复发组比较：男、女复发组FT3均较首发组升高,但无显著差异(P=0.527、P=0.633)；男、女复发组FT4较首发组显著升高(P=0.007、P=0.019)；男、女复发组TSH较首发组高,但无显著差异(P=0.283、P=0.175)。结论 (1)抑郁症患者体内雌二醇水平下降,反复发作女性抑郁症患者体内雌二醇下降更明显,提示雌二醇下降可能是抑郁症的危险因素； (2)睾酮水平下降可能导致男性抑郁症的发生； (3)反复发作的抑郁症患者FT4水平显著下降,可能存在更为明显的甲状腺系统水平异常。
[Abstract]:Purpose To investigate the changes of serum thyroid hormones and sex hormone levels in the patients with first depression and recurrent depression , and to understand the pathogenesis of depression and provide theoretical basis for its clinical treatment . method A case - control study was conducted to collect 60 healthy controls ( control group ) of 118 patients with depression ( experimental group ) and HAMD8 score ( control group ) , which were divided into two subgroups : male and female in the experimental group and the healthy control group . The levels of serum free triiodide ( FT3 ) , free thyroid hormone ( FT4 ) , thyroid stimulating hormone ( TSH ) , estrogen ( E2 ) , progesterone ( P ) and testosterone ( T ) were measured by electrochemical luminescence immunoassay . Statistical significance was expressed by Chi - square test , two - sample t - test , 尾 = 0.05 and P0.05 . Results Comparison of sex hormone among three groups of primary , recurrent and control groups ( 1 ) Compared with the control group , the level of serum estradiol in the first group was significantly lower than that in the control group ( P0.01 ) . The testosterone level in the first group was significantly lower than that in the control group ( P = - 0.034 ) . ( 2 ) Compared with the control group , the serum estradiol levels in the patients with recurrent male and female depression were significantly lower than those in the normal control group ( P0.01 ) . The levels of testosterone in the patients with recurrent male depression were significantly lower than those in the control group ( P = 0 . 542 ) . There was no significant difference between the two groups ( P = 0.294 ) . There was no significant difference between the two groups ( P = 0.294 ) . There was no significant difference between the two groups ( P = 0.294 ) . There was no significant difference between the two groups ( P = 0.378 , P = 0.626 ) . Comparison of thyroid hormones in primary , recurrent and control groups ( 1 ) Compared with the control group , the FT3 of male and female was higher than that of the control group ( P = 0.682 , P = 0.735 ) , but there was no significant difference between FT4 and control group ( P = 0.025 , P = 0.034 ) , but there was no significant difference ( P = 0.845 , P = 0.503 ) . ( 2 ) Compared with the control group , there was significant difference between the relapse group and the control group ( P = 0.012 , P = 0.027 ) ; the male and female relapse group FT4 had significant difference compared with the control group ( P = 0 . 38 , P = 0 . 022 ) ; the TSH of the male and female relapse group was lower than that of the control group , but there was no significant difference ( P = 0.734 , P = 0.725 ) . ( 3 ) Compared with the recurrence group , the FT3 of male and female relapse group was higher than that in the first group ( P = 0.527 , P = 0.633 ) , but there was no significant difference between male and female relapse group FT4 ( P = 0.007 , P = 0.019 ) , but there was no significant difference between male and female relapse group ( P = 0.283 , P = 0.175 ) . Conclusion ( 1 ) The level of estradiol in the patients with depression decreased , and the decrease of estradiol in the patients with recurrent female depression was more obvious , suggesting that the decrease of estradiol could be a risk factor for depression ; ( 2 ) The decrease of testosterone level may lead to depression of male ; ( 3 ) The level of FT4 in patients with recurrent depression was significantly decreased , and there might be a more obvious level abnormality of thyroid system .

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.4

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