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目的:了解青少年双相障碍不同亚型患者的临床特征及治疗前后甲状腺功能水平的差异。方法:采用电化学发光法分别在治疗前、治疗1月后测定住院双相障碍患儿149例和50例正常青少年对照组的血清三碘甲状腺原氨酸Ttriiodothyronine,T3)、甲状腺素(Thyroxine,T4)、游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)和促甲状腺激素(Thyroid-stimulating hormone,TSH)水平,按照目前发作形式分为躁狂组49例、抑郁组80例和混合组20例,比较3组间临床特征及治疗前后甲状腺功能水平。结果:躁狂组在总病程(F=8.237,P<0.001)和本次病程(F=5.228,P<0.05)的时间上低于抑郁组和混合组,躁狂组非核心家庭(离异、丧偶)的比例高于抑郁组和混合组(χ~2=6.200,P<0.05);混合组伴有精神病性症状的比例高于躁狂组和抑郁组(χ~2=7.449,P<0.05)。躁狂组、抑郁组和混合组治疗前后的T3、T4值及治疗后的FT4值低于对照组(F=49.214,27.303,12.882,P<0.001);躁狂组在治疗前的FT3值高于其他3组(F=5.512,P<0.001);躁狂组治疗后的TSH值高于抑郁组和对照组,并且混合组治疗后的TSH值高于对照组(F=8.752,P<0.001),差异有统计学意义。结论:青少年双相障碍不同亚型存在不同的临床特征,在治疗前后与正常青少年的比较中具有不同的甲状腺素水平。
Objective: To understand the clinical characteristics of patients with different subtypes of adolescents with bipolar disorder and the difference of thyroid function before and after treatment. Methods: Electrochemiluminescence method was used to measure serum triiodothyronine (T3), thyroxine (Thyroxine) in 149 cases of hospitalized children with bipolar disorder and 50 normal control group before treatment, T4, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were divided into the manic group 80 cases of depression group and 20 cases of mixed group. The clinical characteristics and thyroid function before and after treatment were compared between the three groups. Results: The manic group was lower than the depression group and the mixed group in the duration of the disease (F = 8.237, P <0.001) and the course of the disease (F = 5.228, P <0.05) (Χ ~ 2 = 6.200, P <0.05). The proportion of psychotic symptoms in the mixed group was higher than that in the manic and depression groups (χ ~ 2 = 7.449, P <0.05) ). Manic group, depression group and mixed group before and after treatment of T3, T4 values and after treatment of FT4 value was lower than the control group (F = 49.214,27.303,12.882, P <0.001); manic group FT3 before treatment high (F = 5.512, P <0.001). TSH value in manic group was higher than that in depression group and control group, and TSH value in mixed group was higher than that in control group (F = 8.752, P <0.001) ),The difference was statistically significant. CONCLUSIONS: There are different clinical characteristics of different subtypes of adolescents with bipolar disorder and different levels of thyroxine compared with normal adolescents before and after treatment.