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[精神情感性疾病患者甲状腺功能的研究(作者译)]

[A study of thyroid function in patients with psychoaffective disease (author's transl)].

作者信息

Schlienger J L, Kapfer M T, Demangeat C, Sapin R, Singer L

出版信息

Nouv Presse Med. 1981 Feb 14;10(6):401-2.

PMID:7220333
Abstract

The purpose of the present study was to investigate dysfunctions in thyroid gland secretion and regulation among patients with manic-depressive psychosis. Plasma levels of thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH) were measured by radioimmune assays, and TSH responsiveness (delta TSH) to synthetic TSH-releasing hormone (TRH) 250 microgram IV was determined in 20 untreated patients, 19 patients under neuroleptics and 19 patients under antidepressants. Untreated patients were compared with 15 age - and sex-matched controls. They were found to have significantly lower plasma T3 levels than controls (121.0 +/- 6.0 ng/dl as against 144.5 +/- 3.3 ng/dl; p less than 0.01) and blunted TSH response to TRH (delta TSH 4.1 +/- 0.6 instead of 12.6 +/- 2.1). Other thyroid function parameters were unchanged. Under neuroleptic treatment T3 levels tended to increase and delta TSH returned to normal. Manic-depressive psychosis is characterized by hypothalamic-pituitary dysfunction. Thyroid secretion is normal, and the decrease in T3 is probably due to impaired peripheral T4 to T3 conversion.

摘要

本研究的目的是调查躁狂抑郁症患者甲状腺分泌和调节功能障碍。采用放射免疫分析法测定血浆甲状腺素(T4)、三碘甲状腺原氨酸(T3)和促甲状腺激素(TSH)水平,并对20例未治疗患者、19例接受抗精神病药物治疗的患者和19例接受抗抑郁药物治疗的患者进行静脉注射250微克合成促甲状腺激素释放激素(TRH)后的TSH反应性(△TSH)测定。将未治疗患者与15例年龄和性别匹配的对照者进行比较。发现他们的血浆T3水平显著低于对照组(分别为121.0±6.0纳克/分升和144.5±3.3纳克/分升;p<0.01),且对TRH的TSH反应迟钝(△TSH为4.1±0.6,而对照组为12.6±2.1)。其他甲状腺功能参数未发生变化。在抗精神病药物治疗下,T3水平趋于升高,△TSH恢复正常。躁狂抑郁症的特征是下丘脑 - 垂体功能障碍。甲状腺分泌正常,T3降低可能是由于外周T4向T3转化受损所致。

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