难治性抑郁症患者的甲状腺功能及对48小时睡眠剥夺的反应
Thyroid function and response to 48-hour sleep deprivation in treatment-resistant depressed patients.
作者信息
David M M, Owen J A, Abraham G, Delva N J, Southmayd S E, Wooltorton E, Lawson J S
机构信息
Department of Psychiatry, Queen's University and Kingston Psychiatric Hospital, and School of Medicine, Queen's University (EW), Kingston, Canada.
出版信息
Biol Psychiatry. 2000 Aug 15;48(4):323-6. doi: 10.1016/s0006-3223(00)00899-4.
BACKGROUND
Clinical depression is associated with abnormalities of the hypothalamic-pituitary-thyroid axis. Changes in thyroid function during sleep deprivation may be related to its antidepressant effects.
METHODS
Levels of thyroid-stimulating hormone, tri-iodothyronine, tri-iodothyronine uptake, thyroxine, and free thyroxine were measured before, during, and after a 48-hour sleep deprivation in nine treatment-resistant depressed patients. Clinical state was assessed every 4 hours. A retrospective study of 26 similar patients was added for cross-validation.
RESULTS
Significant increases in thyroid-stimulating hormone and tri-iodothyronine during sleep deprivation were not correlated with clinical improvement. Sleep deprivation responders had lower tri-iodothyronine uptake levels than nonresponders in both the prospective (p <.02) and the retrospective (p <.03) samples.
CONCLUSIONS
The lower tri-iodothyronine uptake values in responders may identify a subgroup of depressed patients who respond to sleep deprivation by virtue of some abnormality of the hypothalamic-pituitary-thyroid axis that is temporarily corrected by sleep deprivation.
背景
临床抑郁症与下丘脑 - 垂体 - 甲状腺轴异常有关。睡眠剥夺期间甲状腺功能的变化可能与其抗抑郁作用有关。
方法
对9例难治性抑郁症患者在48小时睡眠剥夺前、期间和之后测量促甲状腺激素、三碘甲状腺原氨酸、三碘甲状腺原氨酸摄取、甲状腺素和游离甲状腺素水平。每4小时评估一次临床状态。增加了对26例类似患者的回顾性研究以进行交叉验证。
结果
睡眠剥夺期间促甲状腺激素和三碘甲状腺原氨酸的显著增加与临床改善无关。在前瞻性（p <.02）和回顾性（p <.03）样本中，睡眠剥夺反应者的三碘甲状腺原氨酸摄取水平均低于无反应者。
结论
反应者较低的三碘甲状腺原氨酸摄取值可能识别出一组抑郁症患者，他们因下丘脑 - 垂体 - 甲状腺轴的某些异常而对睡眠剥夺有反应，而这种异常可通过睡眠剥夺得到暂时纠正。
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