激素水平与农村围绝经期女性情绪障碍的流行病学探讨

An epidemiologic study on hormone levels and perimenopausal women emotional disorders in rural areas

目的:了解江西农村地区围绝经期情绪障碍者体内不同激素水平及变化特点。方法:用多阶段整群随机抽样方法,采用《焦虑自评量表》(self-rating anxiety scale,SAS)、《抑郁自评量表》(self-rating depression scale,SDS)并结合某些临床症状及体征,对靖安和分宜两县40～56岁的妇女进行筛查。内容包括一般情况,焦虑和抑郁的评定,部分女性血中雌二醇(estradiol,E2),促卵泡生成激素(follicle-stimulating hormone,FSH),黄体生成素(luteinizing hormone,LH)等3种激素水平的放射免疫检测。结果:调查围绝经期女性613例,采集有效血样85份,情绪障碍患病率27.89%,其中焦虑患病率24.80%,抑郁患病率14.68%。E2、FSH、LH水平在情绪障碍者与无情绪障碍者之间无明显差异(P>0.05);在不同年龄段的情绪障碍者及不同月经周期的情绪障碍者之间有显著差异(P<0.05)。处于卵泡期的焦虑者FSH水平比无焦虑者高,月经周期不正常的抑郁者FSH水平高于无抑郁者,且差异均有统计学意义(P<0.05)。结论:未发现情绪障碍发生与否同E2水平变化有直接关系,但焦虑和抑郁的发生与FSH水平有统计学上的联系。

Objective：To understand the hormone levels and changing characteristics of perimenopausal women emotional disorders in the rural areas of Jiangxi Province.Methods：The objects of the study were the women aged 40 to 56 in Jing＇an and Fenyi,selected by the method of multi-stage cluster random sampling.With the SAS,SDS and some clinical symptoms and signs,the survey was carried out,including the ordinary circumstances,anxious and depression evaluation,and the levels of E2,FSH and LH.Result：Six hundred and thirteen perimenopausal women were investigated,and 85 blood samples were gathered.The prevalence rate of emotional disorders was 27.90%,in which the prevalence rate of anxiety was 24.8% and the prevalence rate of depression was 14.68%.The levels of E2,FSH and LH were the same for people whether they had emotional disorders or not（P0.05）,but there were significant differences among groups of varied ages and various menstrual cycles（P0.05）.In follicular phase, the anxiety person＇s level of FSH was higher than that of the healthy one（P0.05）.When the menstrual cycle was not normal,the women with depression also had a higher FSH level（P0.05）.Conclusion：It is found that there is no direct relation between the occurrence of emotional disorders and the level of E2,but the occurrence of anxiety and depression are statistically linked with the level of FSH.