T3、FT3、T4、FT4、TSH、TGAb、TPOAb检测在评估精神性疾病患者甲状腺功能中的应用

Combined detection of T3/FT3, T4/FT4, TSH, TGAb and TPOAb for thyroid function in psychosis patients

关键词:  甲状腺功能  精神分裂症  抑郁症  双向情感障碍

Key words:  thyroid function  schizophrenia  depression  bipolar disorder

摘要:

摘 要：目的　了解三碘甲状腺原氨酸（T3）、游离T3（FT3）、甲状腺素（T4）、游离T4（FT4）、促甲状腺素（TSH）、甲状 腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）在精神性疾病患者甲状腺功能评估中的应用。方法　对 106 例 精神分裂症（精神分裂症组）、77 例抑郁症（抑郁症组）、47 例双相情感障碍患者（双相情感障碍组）及 77 例健康体检者（对 照组）进行T3、FT3、T4、FT4、TSH、TGAb及TPOAb检测，采用受试者工作特征（ROC）曲线分析各项指标检测的敏感度 和特异度。结果　精神分裂症组TSH、FT4、TGAb、TPOAb水平高于对照组（P<0.05）；抑郁症组TSH和T3 水平低于对照 组，而FT4、TGAb、TPOAb水平高于对照组（P<0.01）；双相情感障碍组T3 和T4 水平低于对照组，而TSH、TGAb、TPOAb 水平高于对照组（P<0.01 或 0.05）。多项指标联合可明显提高甲状腺功能诊断效能，以 7 项联合指标诊断效能最高，AUC 均≥0.87。结论 T3、FT3、T4、FT4、TSH联合TGAb、TPOAb检测可用于评估精神性疾病患者的甲状腺功能。

Abstract:

Abstract: Objective To study the combined detection of T3/FT3, T4/FT4, thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) for evaluating thyroid function in psychiatric disorders. Methods Serum T3/FT3, T4/FT4, TSH, TGAb and TPOAb levels were determined in 106 schizophrenia, 77 depression and 47 bipolar disorder patients and 77 healthy controls. The detection sensitivity and specificity of each parameter were assessed using receiver-operating characteristic (ROC) curve. Results FT4, TSH, TGAb, and TPOAb levels were higher in schizophrenia group than in control group (P<0.05). Compared with control group, T3 and TSH levels were lower, while FT4, TGAb and TPOAb levels were higher in depression group (P<0.01); T3 and T4 levels were lower, whereas TSH, TGAb and TPOAb levels were higher in bipolar disorder group (P<0.01 or 0.05). Combined detection of multiple parameters could significantly improve the diagnostic efficiency, with AUC≥0.87 of each parameter and the highest efficiency of combined seven indexes. Conclusion Combined detection of T3, FT3, T4, FT4, TSH, TGAb and TPOAb could be useful for assessing thyroid function in patients with psychiatric disorders.