首發(fā)精神分裂癥治療前后甲狀腺相關(guān)激素水平變化的研究

張怡 邱聰龍 周東升 陳贊 陳壽林 劉靈江 徐永明 吳向平

[摘要] 目的 觀察首發(fā)精神分裂癥治療前后甲狀腺相關(guān)激素水平變化。 方法 選取109例首發(fā)精神分裂癥患者（觀察組）和113名健康體檢者（對照組）作為研究對象。觀察在接受抗精神病藥物治療前、接受藥物治療后1個月及第12月、18月的甲狀腺相關(guān)激素水平。依據(jù)患者出院后有無連續(xù)服藥，將觀察組分為服藥組（55例）和未服藥組（54例），比較兩組治療前后的甲狀腺相關(guān)激素水平。 結(jié)果 一般資料比較：觀察組、對照組性別構(gòu)成，年齡，差異無統(tǒng)計學意義（P>0.05）。治療前，觀察組FT3、TT4、TSH水平高于對照組;治療后，觀察組FT4、TT3水平低于對照組;觀察組治療前后對照，F(xiàn)T3、FT4、TT3、TT4較前下降，差異均有統(tǒng)計學意義（P<0.05）。未服藥組治療前和12月時FT3、FT4、TT3、TT4、TSH水平比較，差異均無統(tǒng)計學意義（P>0.05）。服藥組18月時FT4、TT3、TT4均低于治療前水平;未服藥組18月時僅FT4、TT4低于治療前水平，差異有統(tǒng)計學意義（P<0.05）。 結(jié)論 精神分裂癥患者的FT3、TT4、TSH水平較正常人增高;FT3、TT4水平降低是疾病好轉(zhuǎn)的信號;連續(xù)服用抗精神病藥物會使患者的FT3、FT4、TT3、TT4水平下降;中斷服藥，甲狀腺相關(guān)激素會恢復至未服藥水平。

[關(guān)鍵詞] 精神分裂癥;首發(fā);甲狀腺相關(guān)激素;停藥

[中圖分類號] R749.3? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0033-05

Study on the changes of thyroid-related hormone levels before and after treatment in first-episode schizophrenia

ZHANG Yi? ?QIU Conglong? ?ZHOU Dongsheng? ?CHEN Zan? ?CHEN Shoulin? ?LIU Lingjiang? ?XU Yongming

WU Xiangping

Department of Psychiatry，Ningbo Kangning Hospital，Ningbo? ?315201，China

[Abstract] Objective To observe the changes of thyroid-related hormones before and after treatment of first-episode schizophrenia. Methods A total of 109 patients with first-episode schizophrenia （the observation group） and 113 healthy subjects （the control group） were selected as the research objects. The levels of thyroid-related hormones were observed before receiving antipsychotic drugs， one month， 12 months，and 18 months after receiving the drugs.According to whether the patients were taking medication continuously after discharge，the observation group was divided into the medication group （55 cases） and non-medication group （54 cases）. The levels of thyroid-related hormones before and after treatment were compared between the two groups. Results There was no statistically significant difference in gender composition and age between the observation group and the control group （P>0.05）. Before treatment，the levels of FT3， TT4， and TSH in the observation group were higher than those in the control group.After treatment，the levels of FT4 and TT3 in the observation group were lower than those in the control group，and the difference was statistically significant （P<0.05）.There was no statistical difference in the levels of FT3， FT4， TT3， TT4， and TSH before treatment and at 12 months after treatment in the non-medication group （P>0.05）. FT4， TT3， and TT4 in the medication group at 18 months after treatment were lower than the pre-treatment level. Only FT4 in the non-medication group at 18 months after treatment was lower than the pre-treatment level， and the difference was statistically significant （P<0.05）. Conclusion The levels of FT3， TT4， and TSH in patients with schizophrenia are higher than those in normal people.The reduction of FT3 and TT4 levels is a sign of improvement. Continuously taking antipsychotic drugs will reduce the levels of FT3， FT4， TT3， and TT4 in patients.When the medication is interrupted， thyroid-related hormones will return to untreated levels.