上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

双相障碍躁狂患者甲状腺激素与睡眠需要减少的相关性研究

 黄佳1,陈俊1,王勇1,洪武1,苑成梅2,汪作为3,粟幼嵩1,胡莺燕1,曹岚1,方贻儒1   

  1. 1.上海交通大学 医学院附属精神卫生中心心境障碍科， 上海 200030； 2.上海交通大学 医学院附属精神卫生中心临床一科， 上海 200030； 3.上海虹口区精神卫生中心， 上海 200083
  • 出版日期:2016-05-28 发布日期:2016-05-26
  • 通讯作者: 方贻儒, 电子信箱: yirufang@aliyun.com。
  • 作者简介:黄佳（1983—）， 女， 住院医师， 硕士; 电子信箱: kittyhj_2000@aliyun.com。
  • 基金资助:

     “十二五”国家科技支撑项目（2012BAI01B04）；国家自然科学基金重大研究计划培育项目（91232719） ；上海市精神疾病临床医学中心项目（2014）；国家临床重点专科-上海市精神卫生中心（卫生部医政司2011-873）；国家自然科学基金青年科学基金项目（81201056；81301159）;上海市卫生局青年科研项目(201344127)；上海市精神卫生中心院级国际合作课题（2013-YJGJ-06）

Correlation between thyroid hormones and the need for reduced duration of sleep for patients with bipolar disorder

HUANG Jia1, CHEN Jun1, WANG Yong1, HONG Wu1, YUAN Cheng-mei2, WANG Zuo-wei1, SU You-song1, HU Ying-yan1, CAO Lan1, FANG Yi-ru1   

  1. 1.Department of Mood Disorders, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2.First Clinical Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 3.Shanghai Hongkou District Mental Health Center, Shanghai 200083, China
  • Online:2016-05-28 Published:2016-05-26
  • Supported by:

    National Science and Technology Pillar Program during “the 12th Five-year Plan” Period(2012BAI01B04); Training Program of Major Research Plan of National Natural Science Foundation of China, 91232719; Project of Shanghai Mental Disease Clinical Center, 2014； National Key Clinical Program-Shanghai Mental Health Centre, 2011-873； National Natural Science Foundation of China, 81201056, 81301159； Research Program for Young Scientists of Shanghai Municipal Bureau of Health, 201344127； College Level International Cooperation Projects of Shanghai Mental Health Center, 2013-YJGJ-06

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摘要：

目的 探讨双相障碍躁狂患者血清甲状腺激素水平与睡眠需要减少之间的相关性。方法 将122例双相障碍躁狂患者，按照是否伴发睡眠需要减少分为2组，比较2组人口学特征及甲状腺激素水平；采用Spearman法分别对2组患者甲状腺激素与临床症状的相关性进行分析；对睡眠需要减少的危险因素采用Logistic回归分析。结果 与不伴睡眠需要减少的患者相比，伴睡眠需要减少的患者血清促甲状腺激素（TSH）水平较低[分别为（2.46±1.74）mU/L和 （3.47±2.65） mU/L]，甲状腺素（T4）水平较高[分别为（90.91±31.59） nmol/L和（76.80±38.55）nmol/L]，差异均有统计学意义（P=0.046，P=0.048）。在伴有睡眠需要减少的患者中，甲状腺激素与精神运动性激越和过度担忧、社交活动增多和纠缠唠叨、使用精神活性物质呈正相关；不伴睡眠需要减少的患者，仅血清三碘甲状腺原氨酸水平（T3）与社交活动增多呈正相关（P=0.329）。Logistic回归分析结果显示，TSH、T4与睡眠需要减少存在相关性（OR=1.303, P=0.023;OR=0.986，P=0.045）。 结论 在双相障碍躁狂患者中，甲状腺激素水平可能是影响患者睡眠需要量和其他临床症状的潜在因素，睡眠需要减少与甲状腺激素的关系可能为改进临床治疗措施提供有益的信息。

关键词: 双相障碍, 躁狂, 甲状腺激素, 睡眠需要减少

Abstract:

Objective To explore the correlation between the serum thyroid hormone level and the need for reduced duration of sleep for patients with bipolar disorder (BPD). Methods One hundred and twenty two BPD patients were assigned to two groups on the basis of whether the duration of sleep needed to be reduced. Demographic characteristics and thyroid hormone level were compared between two groups. Spearmans analysis was used to analyze the correlation between the thyroid hormone level and clinical symptoms for two groups. Logistic regression analysis was employed to assess risk factors for the duration of sleep needed to be reduced. Results Compared with patients whose duration of sleep did not need to be reduced, patients whose duration of sleep needed to be reduced had a lower serum thyroid stimulating hormone (TSH) level [(2.46±1.74) mU/L vs (3.47±2.65) mU/L] and a higher tetraiodothyronine (T4) level [(90.91±31.59) nmol/L vs (76.80±38.55) nmol/L]. The differences were statistically significant (P=0.046，P=0.048). In patients whose duration of sleep needed to be reduced, thyroid hormone level was positively correlated to clinical symptoms such as psychomotor agitation, excessive worry, increased social activities, nagging, and the use of psychoactive substances. In patients whose duration of sleep did not need to be reduced, only the serum triiodothyronine (T3) level was positively correlated to increased social activities (P=0.329). Logistic regression analysis revealed that TSH and T4 levels were correlated to the need for reduced duration of sleep (OR=1.303, P=0.023; OR=0.986，P=0.045). Conclusion The thyroid hormone level may be a potential factor influencing the duration of sleep and other clinical symptoms in patients with BPD. The correlation between thyroid hormones and the need for reduced duration of sleep may provide beneficial information for improving the treatment of BPD.

Key words: bipolar disorder, mania, thyroid hormone, reduced need for sleep