Correlative Study On Changes Of Serum Thyroxine And Cortisol Levels In Patients With Bone Tumour Associated With Depression

Background Based on the idea of holistic health as a new medical model of "bio-psycho-social",more and more researches begin to attach importance to the impact of mental health on the quality of life of cancer patients.Patients with bone tumor should undergo surgery or even radiotherapy,chemotherapy and other long-range comprehensive treatment.Facing bone tumors with high disability rate,relapse rate and high mortality,patients often face the long-term endure pain,dysfunction and even limb dilemma,often cause their psychological disorders to trigger a series of stress reactions.Most of the current researches focus on the common tumors such as lung cancer,breast cancer and gastrointestinal cancer,while few in China have studied the depression-related and stress-related hormone in bone cancer.Objective To investigate the relationship between the changes of serum thyroxine and cortisol levels and the detection rate of depression and the effect of intervention in patients with bone tumors.Methods Methods from January 2016 to January 2017,64 patients with pathologically diagnosed bone tumors were treated in the bone and soft tissue department of Gansu cancer hospital.The results of Hamilton Depression Scale(HAMD)were divided into two groups:29 patients with depression group(D+)HAMD>8 and 35 patients with non-depression group(D-)HAMD≤5.At the same time,33 healthy subjects served as normal controls.Three groups of depressive symptoms were assessed at 0 and 4 weeks after admission,and serum thyroxine and plasma cortisol levels were measured simultaneously.Results 1.The incidence of depression in bone tumor patients was 45.3%,and the incidence rate of advanced patients was 56.5%.The severity of depression was the highest in 44-60 years old,and the unmarried patients had higher depression than married patients(P<0.05).2.Before the antidepressant treatment,the CORT level of tumor group was increased compared with the healthy group(P<0.05);and the T4 decreased and the CORT level increased with the increase of depression(P<0.05).3.Compared with the healthy group,the total score of HAMD and the scores of each factor in tumor group were higher,especially in depression,suicidal idea,work and interest,the difference was statistically significant(P<0.05),except mental anxiety,physical anxiety,hypochondria and other factors.4.After 4 weeks of antidepressant and comprehensive psychological intervention,T3 increased and CORT decreased in the tumor group(P<0.05),and the scores of HAMD and each factor in the depression group decreased(P<0.05),except for diurnal variation factors.5.Before the comprehensive intervention,the total score of HAMD in the tumor group was positively correlated with the level of CORT(P<0.05),and the correlation of other factors was not statistically significant(P>0.05).Conclusion The incidence of depressive disorder was higher in patients with bone tumors,and the distribution of age and marital status was obvious.At the same time,the hypothalamic-pituitary-thyroid axis was changed in patients with depression,which was consistent with other depressive groups.The changes of the Hypothalamic-pituitary-adrenal axis and plasma cortisol levels may be associated with tumor patients with depression prompted.