关键词: 抑郁, 免疫系统疾病, 干燥综合征, 磁共振成像, 甲状腺功能减退症

Abstract: Objective　To explore the causes of Sjogren syndrome （SS） complicated by depression and the relationship with neurologic and endocrine changes.Methods　Two hundred and twenty-five patients with SS who were admitted to the Department of Clinical Psychology and Department of Rheumatology in the First People's Hospital of Yunnan Province from July 2015 to July 2017 were selected.The patients were divided into a depression group，consisting of 59 patients with depressive episodes，and a control group，consisting of 166 patients.Cranial magnetic resonance imaging-weighted and magnetic sensitive-weighted scans were performed on the frontal lobe，temporal lobe，occipital lobe，cerebellum，brainstem，and basal ganglia to detect ischemic cerebrovascular disease，as well as hemorrhagic cerebrovascular disease.Thyroid function，including thyrotropin （TSH），tetraiodothyronine （T4），triiodothyronine （T3），free tetraiodothyronine （FT4），free triiodothyronine （FT3），thyroglobulin antibody （aTG），thyroid peroxidase antibody （TPOAb），was measured.The incidence of liver damage，renal impairment，chronic heart failure，and pulmonary fibrosis was also recorded.Results　The incidence of ischemic cerebrovascular disease in the frontal lobe，temporal lobe，occipital lobe，cerebellum，and basal ganglia was higher in the depression group than the control group （P<0.05）.In the depression group，the incidence of ischemic cerebrovascular disease in the frontal lobe was higher than temporal lobe，the occipital lobe，cerebellum，and brainstem and basal ganglia，and the incidence of ischemic cerebrovascular disease in the temporal lobe and basal ganglia was higher than cerebellum （P<0.05）.The incidence of hemorrhagic cerebrovascular disease in the frontal lobe，temporal lobe，occipital lobe，and basal ganglia was higher in the depression group than the control group （P<0.05）.In the depression group，the incidence of hemorrhagic cerebrovascular disease in the frontal lobe of patients with depression was higher than the occipital lobe，cerebellum，and brainstem （P<0.05）.The levels of TSH，aTG，and TPOAb in the depression group were higher than the control group，while the levels of T3 and FT3 were lower than the control group （P<0.05）.The incidence of pulmonary fibrosis in the depression group was higher than the control group （P<0.05）.Conclusion　SS complicated with depression may be associated with cerebral vascular damage caused by SS，which may be related to cerebral ischemia and bleeding related to emotion.And it may be related to SS causing thyroid dysfunction and complicated vital organ damage，thus affecting the quality of life.

Key words: Depression, Immune system diseases, Sjogren syndrome, Magnetic resonance imaging, Hypothyroidism