抗抑郁药治疗青少年抑郁症伴自杀意念的患者的甲状腺激素水平

张佳俐; 王小泉; 徐慧; 王祖森; 汪莲籽; 陈方方; 杨涛

doi:10.19428/j.cnki.sjpm.2023.22732

抗抑郁药治疗青少年抑郁症伴自杀意念的患者的甲状腺激素水平

Effect of antidepressants on thyroid hormone level in adolescent depression with suicidal ideation

摘要

摘要:
目的比较伴与不伴自杀意念青少年首发抑郁症患者的甲状腺激素水平差异，探讨甲状腺激素与其自杀意念间关联性及抗抑郁药治疗变化。
方法选取2020年9月—2022年7月精神专科医院100例首发抑郁症青少年患者，将100例患者依据自杀意念量表（SIOSS）列为非自杀意念（n=52）和自杀意念组（n=48）。比较两组在一般人口学资料、促甲状腺激素（TSH）、三碘甲腺原氨酸（T3）、甲状腺素（T4）、游离三碘甲腺原氨酸（FT3）和游离甲状腺素（FT4）水平上的差异、甲状腺激素水平与HAMD⁃17评分的相关性、抗抑郁药治疗 6周后激素水平的变化。
结果非自杀意念组在FT3、FT4、T4水平上均比自杀意念组高；经抗抑郁药治疗6周后，自杀意念组治疗后的FT3、FT4、T4水平均比治疗前高；男性非自杀意念组的FT3水平比自杀意念组高；女性非自杀意念组的FT4、T4水平比自杀意念组高（均P<0.05）。
结论伴与不伴自杀意念青少年首发抑郁症患者的甲状腺激素水平上存在差异且伴自杀意念的患者经抗抑郁药治疗后有明显变化。

Abstract:
Objective To compare the differences in thyroid hormone levels between adolescents with and without suicidal ideation， and to explore the association between thyroid hormone/suicidal ideation and the antidepressant treatment.
Methods A total of 100 patients were divided into non-suicidal ideation group and suicidal ideation group according to the SIOSS. The levels of thyroid-stimulating hormone （TSH）， triiodothyronine （T3）， thyroxine （T4）， free triiodothyronine （FT3） and free thyroxine （FT4） were compared between the two groups as well as their changes after 6 weeks of antidepressant treatment.
Results The levels of FT3， FT4 and T4 in the non-suicidal ideation group were higher than those in the suicidal ideation group. After 6 weeks of antidepressant treatment， the levels of FT3， FT4 and T4 in the suicide ideation group were higher than those before the treatment. The FT3 level in the male non-suicidal ideation group was higher than that in the suicidal ideation group. The levels of FT4 and T4 in the female non-suicidal ideation group were higher than those in the suicidal ideation group （all P<0.05）
Conclusion There are differences in thyroid hormone levels between adolescents with and without suicidal ideation （both with first-episode depression）， and patients with suicidal ideation have significant changes after treatment with antidepressants.

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