首发精神分裂症治疗前后甲状腺相关激素水平变化的研究

张怡 邱聪龙 周东升 陈赞 陈寿林 刘灵江 徐永明 吴向平

[摘要] 目的 觀察首发精神分裂症治疗前后甲状腺相关激素水平变化。 方法 选取109例首发精神分裂症患者（观察组）和113名健康体检者（对照组）作为研究对象。观察在接受抗精神病药物治疗前、接受药物治疗后1个月及第12月、18月的甲状腺相关激素水平。依据患者出院后有无连续服药，将观察组分为服药组（55例）和未服药组（54例），比较两组治疗前后的甲状腺相关激素水平。 结果 一般资料比较：观察组、对照组性别构成，年龄，差异无统计学意义（P>0.05）。治疗前，观察组FT3、TT4、TSH水平高于对照组;治疗后，观察组FT4、TT3水平低于对照组;观察组治疗前后对照，FT3、FT4、TT3、TT4较前下降，差异均有统计学意义（P<0.05）。未服药组治疗前和12月时FT3、FT4、TT3、TT4、TSH水平比较，差异均无统计学意义（P>0.05）。服药组18月时FT4、TT3、TT4均低于治疗前水平;未服药组18月时仅FT4、TT4低于治疗前水平，差异有统计学意义（P<0.05）。 结论 精神分裂症患者的FT3、TT4、TSH水平较正常人增高;FT3、TT4水平降低是疾病好转的信号;连续服用抗精神病药物会使患者的FT3、FT4、TT3、TT4水平下降;中断服药，甲状腺相关激素会恢复至未服药水平。

[关键词] 精神分裂症;首发;甲状腺相关激素;停药

[中图分类号] R749.3          [文献标识码] B          [文章编号] 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.