摘要目的 探讨慢性酒依赖患者戒酒期外周甲状腺素水平的变化及其与抑郁情绪的关系.方法 收集21例慢性酒精依赖男性患者(患者组)与21例健康体检男性(对照组),采集一般资料,使用HAMD-24和酒精依赖筛查量表(michigan alcoholism screening test,MAST)进行调查评估.分别测定患者组和对照组血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)、四碘甲状腺氨酸(T4).患者组在戒酒第1周和戒酒第6周分别进行两次量表评定和抽血测定,对照组仅在入组时进行一次与患者组相对应的资料采集.结果 与对照组相比,患者组戒酒第1周FT3[(4.34± 1.01) pmol/L,(5.85± 0.78) pmol/L,t=5.56,P＜0.01]水平明显降低,TSH[(2.62±0.69) ulU/ml,(1.70±0.81) uIU/ml,t=-3.96,P＜0.01]水平明显升高,戒酒第6周FT3[(5.22±0.92) pmol/L,(5.85±0.78) pmol/L,t=2.45,P＜0.05]、T3[(1.54±0.54) nmol/L,(1.84±0.34) nmol/L,t=2.92,P＜0.01]水平明显降低;患者组戒酒第1周与戒酒第6周相比,FT3(t=-4.12,P＜0.01)、FT4(t=-3.93,P＜0.01)水平明显降低,TSH(t=2.34,P＜0.05)水平明显升高,均差异具有统计学意义.患者组戒酒第1周HAMD-24评分与T3(r=-0.465)、TSH(r=-0.489)呈负相关(均P＜0.05);戒酒第6周HAMD-24评分与FT3、FT4、TSH、T3、T4无相关性(r=-0.303～ 0.047,均P＞0.05).结论 慢性酒依赖患者存在血清甲状腺激素水平紊乱状态,在戒酒期有所恢复,并与抑郁情绪有关.

abstractsObjective To explore the alteration of the peripheral thyroid hormone level in patients with chronic alcohol dependence and its relationship with depressive emotion.Methods Data were collected from 21 male patients with chronic alcohol dependence (case group) and 21 male health control (control group).Hamilton Depression Scale-24 (HAMD-24) and Alcohol Dependence Screening Scale (MAST) were used.The level of thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),triiodothyronine (T3) and four iodine thyroxine (T4) of case group and control group were separately determined.The level of above-mentioned hormones and scale score of case group were evaluated in the first and sixth week of the period of temperance.Data of control group were collected once at baseline.Results The level of FT3 in case group was decreased significantly in the first week of the period of temperance compared with the control group ((4.34± 1.01) pmol/L,(5.85 ± 0.78) pmol/L,t =5.56,P＜ 0.01),while the level of TSH in case group was increased((2.62±0.69) uIU/ml,(1.70±0.81)uIU/ml,t=-3.96,P＜0.01).The level of FT3 and T3 in case group decreased significantly in the sixth week of the period of temperance comparedwith the control group(FT3:(5.22±0.92) pmol/L,(5.85±0.78) pmol/L,t=2.45,P＜ 0.05;T3:(1.54±0.54)pmol/L,(1.84±0.34)pmol/L,t=2.92,P＜0.01).The level of FT3 of the case group in the first week decreased significantly compared with the sixth week in the period of temperance (t=-4.12,P＜0.01),while the level of FT4 were increased significantly (t=-3.93,P＜0.01).In case group,the scores of HAMD-24 and the level of T3 (r=-0.465,P＜0.05),TSH (r=-0.489,P＜0.05) were negative correlation in the first week of the period of temperance.No correlation were observed between the score of HAMD-24 and the level of FT3,FT4,TSH,T3,T4 (r=-0.303-0.047,all P＞ 0.05)in the sixth week of the period of temperance.Conclusion The level of serum thyroid is disordered in patients with chronic alcohol dependence.The disorder will recover in the period of temperance and is associated with depressive emotion.