慢性主观性头晕患者睡眠、情绪及甲状腺 激素水平的变化
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国家自然科学基金(81371459)


Sleep, emotion, and thyroid hormone levels in patients with chronic subjective dizziness
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    摘要:

    目的 探讨慢性主观性头晕患者睡眠质量、情绪障碍及其体内甲状腺激素水平的情况。 方法 采用自填问卷调查方式对68 例慢性主观性头晕患者及60 名健康体检人员进行横断面调查,问卷 包括调查对象基本情况问卷、焦虑自评量表(SAS)、抑郁自评量表(CES-D)、匹兹堡睡眠质量指数(PSQI)。 并对两组患者进行抽血化验比较两组间甲状腺激素水平的异同。结果 慢性主观性头晕患者组PSQI 总分、入睡时间、睡眠时间、睡眠效率、睡眠障碍程度、睡眠药物使用情况均较对照组明显增高(P< 0.01)。 SAS 总分(52.48±14.17)分,CES-D 总分(17.51±9.47)分,63.2%(43/68)的慢性主观性头晕患者合并焦虑 情绪,66.2%(45/68)患者合并抑郁可能。对比两组甲状腺激素水平提示尽管两组均值均在正常范围内, 但慢性主观性头晕患者组促甲状腺素(TSH)水平增高,游离三碘甲状腺原氨酶(fT3)、游离甲状腺素(fT4) 水平较正常有下降趋势,且两组间低fT4 患者所占比例差异有统计学意义(P < 0.05)。结论 慢性主观 性头晕患者普遍存在情绪及睡眠的问题,神经内分泌因素尤其是甲状腺激素水平可能是其中的影响因 素之一,值得进一步完善研究。

    Abstract:

    Objectives To investigate the sleep quality, mood disorder and thyroid hormone level in patients with chronic subjective dizziness( CSD). Methods A cross-sectional self-report survey used to investigate 68 patients with CSD and 60 healthy individuals. The survey included a basic information questionnaire, Self-rating Anxiety Scale( SAS), Center for Epidemiologic Studies Depression Scale( CES-D), and the Pittsburgh Sleep Quality Index( PSQI). The differences in thyroid hormone levels between the two groups were compared by blood sampling assay. Results The total scores of PSQI, sleep time, sleep efficiency, sleep disorder, and sleep pill usage rate in the CSD group were significantly higher than those in the control group (P<0.01). The total score of SAS was( 52.48±14.17), and the total score of CES-D was( 17.51±9.47). 63.2% (43/68) of the patients have anxiety, and 66.2%( 45/68) have depression. Comparison between the two groups' thyroid hormone levels suggested that although the mean values of the two groups were within the normal range, thyroid stimulating hormone( TSH) levels increased in the CSD group and free triiodothyronine T3( fT3) and free thyroxine T4( fT4) levels decreased compared with the control group. There was a statistical difference in the proportion of patients with low fT4 between the two groups( P< 0.05). Conclusions CSD patients generally have emotional and sleep problems. Neuroendocrine factors, especially thyroid level, may be one of the influencing factors, which needs to be further studied.

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孙文静 周菲 杨洋 由春梅 黄流清.慢性主观性头晕患者睡眠、情绪及甲状腺 激素水平的变化[J].神经疾病与精神卫生,2019,19(3):
DOI :10.3969/j. issn.1009-6574.2019.03.003.

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  • 在线发布日期: 2019-05-10