产后抑郁与血清催乳素及孕酮的病例对照研究

A case control study on relationship between postpartum depression and serum progesterone and prolactin levels

目的了解产后抑郁与血清催乳素、孕酮水平的关系。方法用1：1配对巢式病例对照研究方法，对产后3天正常的801名产妇于产后42天、6个月进行随访，根据测评结果分为病例组及对照组，并分别测定其产后3天、42天和6个月时的血清催乳素、孕酮水平，对相关资料进行统计学分析。结果病例组与对照组产后3天的催乳素、孕酮水平经比较有统计学差异（t分别为9．12、12．52，均P〈0．05）；两组产后42天的催乳素、孕酮水平经比较有统计学差异（t=5．83、T=220．00，均P〈0．05）。结论产后低催乳素、孕酮水平可能为产后抑郁的发病原因之一，监测产妇产后血清催乳素、孕酮浓度，对临床预测及治疗产后抑郁有一定的指导意义。

Objective To explore relationships of postpartum depression （PPD） with serum progesterone （P） and prolactin （PRL） levels. Methods In 1：1 matched nested case-control study method, 801 parturients healthy in 3 days after delivery were followed up respectively at 42 days and 6 months after delivery and were assessed with Edinburgh postnatal depression scale （ EPDS）, Hamilton depression scale （HAMD） and general information questionnaires. The parturients with postpartum depression were divided into case group and control group according to their scores in EPDS and HAMD. The levels of PRL and P in the case group and the control group were detected at 3 days, 42 days and 6 months after delivery. All data were analyzed by using SPSS/PC10.0 software. Results At 3 days after delivery, there were singnificant differences in serum P level and serum PRL level between the two groups （t = 9. 12 and 12.52 respectively, both P 〈 0.05）. Also, at 42 days after delivery, in serum P level and serum PRL level, there were significant differences between the two groups （t = 5.83 and T = 220.00 respectively, both P 〈 0.05 ）. Conclusion The lowered serum PRL and P levels maybe one of reasons that induce postpartum depression. Monitoring the serum PRL and P concentrations of parturients is of important guiding significance for predicting and treating postpartum depression.