实用医学杂志 ›› 2021, Vol. 37 ›› Issue (16): 2044-2052.doi: 10.3969/j.issn.1006⁃5725.2021.16.002

• 专题报道 • 上一篇    下一篇

抑郁症自杀未遂与甲状腺激素、血浆皮质醇关联分析

王艳华1, 杨永涛1,2 ,崔利军1,2 ,崔伟1 ,高景娜1, 郑冬瑞1    

  1. 1 河北省精神卫生中心(河北保定 071000);2 济宁医学院(山东济宁 272000)

  • 出版日期:2021-08-25 发布日期:2021-08-25
  • 通讯作者: 崔利军 E⁃mail:cuilijun2013@163.com
  • 基金资助:

    河北省财政厅河北省卫生健康委政府资助临床医 学优秀人才项目(编号:361014)


Analysis of the relationship between attempted suicide and thyroid hormone and plasma cortisol in depres⁃ sion

WANG Yanhua,YANG Yongtao,CUI Lijun,CUI Wei,GAO Jingna,ZHENG Dongrui.   

  1. Hebei Mental Health Center,Baoding 071000,China

  • Online:2021-08-25 Published:2021-08-25
  • Contact: CUI Lijun E⁃mail:cuilijun2013@163.com

摘要:

目的 探讨抑郁症患者自杀未遂与甲状腺激素、血浆皮质醇之间的关系。方法 符合DSM⁃5 抑郁发作诊断标准患者 158 例,评估是否出现自杀未遂,将患者分为自杀未遂组和非自杀未遂组,评估汉 密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA),测量甲状腺激素、血浆皮质醇。结果 自杀未遂组促 甲状腺激素(TSH)、游离甲状腺素(FT4)明显低于非自杀未遂组(P<0.05),自杀未遂组 HAMD 量表总分高 于非自杀未遂组(P<0.05),两组间血浆皮质醇未见差异。按年龄分层,<40岁自杀未遂组FT4水平明显低于 非自杀未遂组(P<0.05)。多因素 logistic 回归分析显示:FT4(OR = 0.029)、TSH(OR = 0.399)、阳性家族史 OR = 5.203)、HAMD量表评分(OR = 1.207)为独立危险因素。结论 自杀未遂组抑郁症存在甲状腺激素紊 乱。家族史阳性,疾病严重程度重,FT4、TSH 越低的患者自杀风险更高,<40岁患者更应关注FT4水平。 

关键词: 抑郁症, 自杀, 皮质醇, 甲状腺激素 ,

Abstract:

Objective To explore the relationship between attempted suicide and thyroid hormone and plasma cortisol in patients with depression. Method A total of 158 inpatients who met the diagnostic criteria of DSM⁃5 depressive episode were collected. The patients were divided into two groups:those with a history of suicide attempted and those without a history of suicide attempted. Hamilton Depression Scale(HAMD)and Hamilton Anx⁃ iety Scale(HAMA)were used to assess the severity of depression and anxiety,respectively. The plasma concentra⁃ tions of thyroid hormone and cortisol were measured. Result The levels of TSH and FT4 in attempted suicide group were significantly lower than those in non ⁃ attempted suicide group(P<0.05). Total HAMD scores were higher in attempted suicide group compared with non ⁃ attempted suicide group(P<0.05). No differences in the plasma cortisol levels were found between the two groups. According to the age stratification,the level of FT4 in the attempted suicide group under 40 years old was significantly lower than that in the non⁃attempted suicide group (P<0.05). Multivariate logistic regression analysis showed that FT4(OR = 0.029),TSH(OR = 0.399),positive family history(OR = 5.203)and HAMD score(OR = 1.207)were high risk factors. Conclusion There is a thyroid hormone irregular in depression with attempted suicide. The patients with positive family history and severe disease,the lower levels of FT4 and TSH,the higher risk of suicide,and the patients less than 40 years old should pay more attention to the level of FT4. No correlation between plasma cortisol and attempted suicide is found in this study.

Key words:

depression, suicide, cortisol, thyroid hormones