产后抑郁症患者血清中雌二醇与孕酮的变化

Changes of estradiol and progestogen in serum of patients with postpartum depression

目的:分析产后抑郁症患者雌孕激素的水平变化,并与正常产妇进行对照。方法:选择2000-01/2005-01佛山市顺德第一人民医院妇产科住院分娩的初产孕妇为调查对象。应用放射免疫方法测定所有150例住院分娩妇女产后第1天的雌激素及孕激素水平,按照美国精神科学会编著的精神障碍诊断与统计手册第4版关于产后抑郁症的诊断标准,将2周内发生抑郁症者分为产后抑郁组(n=18),于第2周末再次测定雌激素及孕激素,并与同期正常产妇中随机选择的18例正常对照组进行比较。两组采集血样均获知情同意。数据以x±s表示,两组的差异用t检验。结果:产后抑郁症患者及对照组均采集到产后第1天及第14天的血样,全部进入结果分析。①产后抑郁症组产后第1天和第14天的血清雌二醇浓度均显著低于正常对照组犤(12.8±1.3),(14.9±1.9)nmol/L,t=3.864,P<0.001;(3.8±0.9),(4.9±1.1)nmol/L,t=3.198,P<0.005犦。②产后第1天两组的孕酮水平无显著差异犤(28.8±9.1),(25.4±9.9)nmol/L,t=0.09,P>0.05犦,产后第14天产后抑郁组孕酮水平高于正常对照组犤(18.8±7.1),(14.1±5.8)nmol/L,,t=2.18,P<0.005犦。结论:产后抑郁症妇女产后存在雌、孕激素的代谢平衡紊乱,雌激素持续性低水平,而孕激素则保持相对较高水平。

AIM： To analyze the changes of estrogen and progestogen levels in patients with postpartum depression, and compare with normal parturiens. METHODS： Totally 150 primiparous parturiens were selected from the Department of Obstetrics and Gynecology, Shunde First Peeple＇s Hospital of Foshan City between January 2000 and January 2005. Their levels of estrogen and progestogen were detected with radioimmunoassay on the 1st postpartum, and those were reexamined at the end of the 2^nd week in the patients were diagnosed to have depression （postpartum depression group, n=18） within 2 weeks according to the diagnostic criteria of postpartum depression in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders compiled by American Psychiatric Association, and the results were compared with those of 18 randomly selected normal parturiens at the same period （normal control group）. The blood samples in both groups were drawn with the permission of all the subjects. The data were expressed as Mean±SD, and the difference between the two groups were analyzed with the t test. RESULTS： The blood samples collected on the 1^st and 14^th days postpartum in both the postpartum involved in the analysis of results. depression group and control group were ① The serum levels of estradiol on the 1^st and 14^th days postpartum were significantly lower in the postpartum depression group than in the control group [（12.8±1.3）, （14.9±1.9） nmol/L, t=3.864, P 〈 0.001; （3.8±0.9）, （4.9±1.1） nmol/L, t=3.198, P 〈 0.005]. ② On the 1^st day postpartum, there was no significant difference in the level of progestogen between the two groups [（28.8±9.1）, （25.4±9.9） nmol/L, t=0.09, P 〉 0.05]. On the 14^th day postpartum, the level of progestogen in the postpartum depression group was higher than that in the control group [（18.8±7.1）, （14.1±5.8） nmol/L, t=2.18, P 〈 0.005]. CONCLUSION： Women with postpartum depression have metabolic disorders of estrogen and progestogen postpartum, the estrogen keeps a low level and progestogen maintains a relatively higher level.