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山东大学学报 (医学版) ›› 2026, Vol. 64 ›› Issue (1): 37-42.doi: 10.6040/j.issn.1671-7554.0.2025.0229

• 重点专题——精神与睡眠问题的机制证据与转化 • 上一篇    下一篇

甲状腺激素与皮质醇水平对双相障碍患者攻击行为的预测

周朝雄,付屹   

  1. 江西省精神病院/南昌大学附属精神病医院, 江西 南昌 330029
  • 发布日期:2026-01-27
  • 通讯作者: 周朝雄. E-mail:Zchaoxx9@163.com
  • 基金资助:
    江西省卫生健康委员会科技计划项目(20204100)

Prediction of aggression behavior in bipolar disorder patients by thyroid hormone and cortisol levels

ZHOU Chaoxiong, FU Yi   

  1. Jiangxi Provincial Mental Hospital / Nanchang University Affiliated Mental Hospital, Nanchang 330029, Jiangxi, China
  • Published:2026-01-27

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摘要： 目的 探讨血清甲状腺素(thyroxine, T4)、三碘甲状腺原氨酸(triiodothyronine, T3)、皮质醇(cortisol, Cor)水平与双相情感障碍(bipolar disorder, BD)患者自知力的关系,分析其对患者攻击行为的预测价值。 方法 选取江西省精神病院2021年6月至2024年6月收治的184例 BD 患者,按有无攻击行为分为攻击行为组(71 例)和非攻击行为组(113 例),另选同期70名健康者作对照组。检测血清 T4、T3、Cor 水平;采用自知力与治疗态度问卷(insight and treatment attitudes questionnaires, ITAQ)评估患者自知力。采用Pearson相关分析 BD 患者血清 T4、T3、Cor 水平与自知力的相关性;采用 logistic 回归分析 BD 患者发生攻击行为的危险因素,通过受试者工作特征(receiver operating characteristic, ROC)曲线分析血清 T4、T3、Cor 水平对 BD 患者发生攻击行为的预测价值。 结果 攻击行为组血清T4、T3、Cor水平高于非攻击行为组,ITAQ 评分低于非攻击行为组,差异有统计学意义(P<0.05)。BD 患者血清T4、T3、Cor水平与自知力呈负相关(r=-0.443、-0.364、-0.461,P<0.001)。血清T4(OR=1.192, 95%CI=1.052~1.352)、T3(OR=1.177, 95%CI=1.036~1.337)、Cor 水平(OR=1.196, 95%CI=1.059~1.351)、婚姻状况(OR=1.175, 95%CI=1.010~1.366)、应激事件(OR=1.183, 95%CI=1.043~1.341)是 BD 患者发生攻击行为的危险因素,ITAQ评分(OR=0.781, 95%CI=0.663~0. 921)与攻击行为的发生风险呈负相关(P<0.05)。血清 T4、Cor 水平预测攻击行为的 AUC 分别为 0.755、0.725。 结论 血清 T4、T3、Cor 水平与 BD 患者自知力呈负相关,血清 T4、Cor 水平对 BD 患者发生攻击行为有一定预测价值。

关键词: 双相情感障碍, 甲状腺素, 三碘甲状腺原氨酸, 皮质醇, 自知力, 攻击行为

Abstract: Objective To explore the relationship between serum levels of thyroxine(T4), triiodothyronine(T3), cortisol(Cor), and the insight of patients with bipolar disorder(BD), and to analyze their predictive value for aggressive behavior in patients. Methods A total of 184 BD patients admitted to Jiangxi Mental Hospital from June 2021 to June 2024 were selected and divided into an aggressive behavior group(71 cases)and a non-aggressive behavior group(113 cases)based on the presence or absence of aggressive behavior. Additionally, 70 healthy individuals were selected as a control group during the same period. Serum levels of T4, T3, and Cor were measured. The insight and treatment attitudes questionnaires(ITAQ)were used to assess the patients insight. Pearson correlation analysis was used to analyze the correlation between serum levels of T4, T3, Cor, and insight in BD patients. Logistic regression analysis was used to analyze the risk factors for aggressive behavior in BD patients. The predictive value of serum T4, T3, and Cor levels for aggressive behavior in BD patients was analyzed by receiver operating characteristic(ROC)curves. Results The serum levels of T4, T3, and Cor in the aggressive behavior group were higher than those in the non-aggressive behavior group, and the ITAQ score was lower than that in the non-aggressive behavior group, with statistically significant differences(P<0.05). Serum levels of T4, T3, and Cor in BD patients were negatively correlated with insight(r=-0.443, -0.364, -0.461, P<0.001). Serum T4(OR=1.192, 95%CI=1.052-1.352), T3(OR=1.177, 95%CI=1.036-1.337), Cor levels(OR=1.196, 95%CI=1.059-1.351), marital status(OR=1.175, 95%CI=1.010-1.366), and stress events(OR=1.183, 95%CI=1.043-1.341)were risk factors for aggressive behavior in BD patients, and ITAQ score(OR=0.781, 95%CI=0.663-0.921)was negatively correlated with the risk of aggressive behavior(P<0.05). The AUCs of serum T4 and Cor levels for predicting aggressive behavior were 0.755 and 0.725, respectively. Conclusion Serum levels of T4, T3, and Cor are negatively correlated with the insight of BD patients, and serum levels of T4 and Cor have certain predictive value for aggressive behavior in BD patients.

Key words: Bipolar disorder, Thyroxine, Triiodothyronine, Cortisol, Insight level, Aggressive behavior

中图分类号: 

  • R749.4
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