产后抑郁症患者血中孤啡肽水平与单胺类递质的相关性(英文)

Correlation of plasm orphanin level and monoamine neurotransmitters in patients with postpartum depression

背景:孤啡肽是近年来才发现的一种重要的生物活性多肽,其在中枢及外周的广泛分布提示它可能有较为广泛的调节整体行为的功能。目的:测定产后抑郁症妇女血孤啡肽及单胺类递质5-羟色胺、多巴胺的含量,探讨产后抑郁症时孤啡肽含量的变化及意义。设计:以诊断为依据的病例对照实验。单位:解放军第二军医大学长征及长海医院妇产科。对象:2002-02/2004-10在解放军第二军医大学长征,长海医院妇产科门诊产后复诊的健康产妇25例(对照组)及发生产后抑郁症的产妇17例(抑郁组)。均为自愿参加者,年龄为21～43岁,文化程度相当。抑郁组均为首次发病,发病时间为产后15～25d,爱丁堡产后抑郁量表总分≥13分。试验对象对本试验的内容知情同意。方法:测定25例健康产妇(对照组)及17例产后抑郁症妇女(抑郁组)静脉血中孤啡肽及单胺类递质含量。①标本采集:抑郁组于发病2周后取血,对照组于产后35d抽血。②测定方法:采用放射免疫测定法测定孤啡肽含量,药盒由美国phoenix公司提供,操作程序严格按药盒说明进行;5-羟色胺及多巴胺测定采用高压液相色谱/电化学检测法。主要观察指标:①抑郁组及对照组血孤啡肽含量及5-羟色胺、多巴胺含量的变化。②抑郁组爱丁保产后抑郁量表总分与孤啡肽含量的相关性。结果:对照组25例健康产妇及抑郁组17例发生产后抑郁症的产妇均纳入结果分析。①与对照组相比,抑郁组孤啡肽含量升高,而5-羟色胺及多巴胺含量则下降(抑郁组及对照组血孤啡肽:(27.39±6.04),(10.37±3.65)ng/L;抑郁组及对照组血5-羟色胺:(0.93±0.21),(1.43±0.36)μmol/L;抑郁组及对照组血多巴胺:(2.15±0.41),(3.64±0.72)μmol/L,P<0.01或0.05)。②抑郁组孤啡肽与5-羟色胺及多巴胺含量呈负相关(r为-0.601及-0.593,P<0.05)。③抑郁组爱丁堡产后抑郁量表总分与孤啡肽含量呈正相关(r=0.512,P<0.05),与5-羟色胺、多巴胺含量呈负相关(r=-0.571,-0.526,P<0.05)。结论:产后抑郁患者血孤啡肽含量增加并与5-羟色胺及多巴胺的含量呈负向相关,与爱丁堡产后抑郁量表评分呈正向相关。

BACKGROUND： Orphanin, which was found in recent years, is an important bioactive polypeptide. Its extensive distribution in the central nervous system and peripheral tissue suggests a function of adjusting global behaviors.OBJECTIVE： To explore the correlation of plasm orphanin level and monoamine neurotransmitters in patients with postpartum depression by determining the levels of orphanin and monoamine neurotransmitters such as 5-hydroxytryptamine （5-HT） and dopamine（DA） in patients.DESIGN： Case-control experiment taking diagnosis as evidence.SETTING： Departments of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS： Twenty-five healthy women and seventeen women patients with postpartum depression after delivery who came in the Department of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA for further consultation during February 2002 to October 2004 were enrolled in this study, and served as control group and postpartum depression group, respectively. All the enrolled women, aged 21 to 43 years, with fair education levels, and voluntarily participated in this study. Women patients of 15 to 25 days after delivery suffered from the incipient postpartum depression with total scores of Edingburgh Postnatal Depression Scale （EPDS） above 13. Informed consents were obtained from all the subjects.METHODS： The levels of orphanin and monoamine neurotransmitters in venous blood from 25 healthy women and 17 women patients with postpartum depression were determined. ① Sample collecting： Blood was taken from women in the postpartum depression group 2 weeks after onset, while from control group 35 days after delivery. ② Assay method：The level of orphanin was determined with radioimmunoassay （RIA）. The reagent kit was provided by phoenix company （USA） and the procedure was strictly performed according to the instructions on the reagent kit. The levels of 5-HT and DA were measured with high-performance liquid chromatography or electrochemical detection method.MAIN OUTCOME MEASURES： ① Changes in the levels of orphanin as well as 5-HT and DA in postpartum depression group and control group. ② Correlation of the total scores of EPDS and the levels of orphanin in postpartum depression group.RESULTS： Twenty-five healthy women and seventeen women patients with postpartum depression after delivery all participated in the result analysis. ① The level of orphanin in the postpartum depression group[（27.39±6.04） ng/L] was significantly higher than that in the control group [（10.37±3.65） ng/L]（P 〈 0.01）,the levels of 5-HT in the postpartum depression group [（0.93±0.21） μmol/L] was remarkably lower than that in the control group[（1.43±0.36） μmol/L]（P 〈0.05） ,and the levels of DA in postpartum depression group[（2.15±0.41） μmol/L] was obviously lower than that in the control group [（3.64±0.72） μmol/L]（ P 〈 0.01）. ②The level of orphanin was negatively correlated with those of 5-HT and DA in postpartum depression group（r = -0.601 , -0.593,P 〈 0.05）. ③ The total scores of EPDS were significantly positively correlated with the level of orphanin （r = 0.512, P 〈 0.05）, and negatively correlated with the levels of 5-HT and DA （r = -0.571,-0.526, P〈 0.05）.CONCLUSION： The level of orphanin in patients with postpartum depression is increased and is negatively correlated with the levels of 5-HT and DA, but positively correlated with the total scores of EPDS.