分娩前后血清催乳素、雌二醇和孕酮水平的变化与产后抑郁症的相关性研究

Association of serum levels of prolactin, estradiol and progesterone with postpartum depression around the time of delivery

目的探讨产后抑郁症与分娩前血清催乳素、雌二醇及孕酮的关系,并提出相关防治措施。方法选择我院2009年12月至2012年9月入院接受治疗的80例产妇作为研究对象,对所有产妇进行产前,产后调查,产前使用汉密尔顿抑郁症测量表排除抑郁症,产后42 d用爱丁堡产后抑郁量表(EPDS)评定,以EPDS总分≥13分为产后抑郁症,以35例产后抑郁症作为抑郁组,其余45例作为对照组,并于分娩前后采用放射免疫方法测定所有产妇的血清催乳素(PRL)、孕酮(P)和雌二醇(E2)水平。结果抑郁组产后5 d,42 d血清PRL显著高于对照组,组间差异具有统计学意义(P<0.05);产前E2抑郁组与对照组差异无统计学意义(P>0.05),产后5 d,42 d的E2、P值与产前比较,抑郁组低于对照组(P<0.05)。结论胎盘娩出后,产后抑郁症的发生同雌二醇,孕酮和催乳素的改变具有密切关系。

Objective To explore the relationship of serum levels of prolactin, estradiol and progesterone with postpartum depression around the time of delivery, and to apply the correlative measures of prevention and treat- ment. Methods A total of 80 parturients from Dec. 2009 to Sep. 2012 were evaluated depression situation with Ham- ilton depression scale before delivery and Edinburgh postnatal depression scale （EPDS） on day 42 after delivery. Scores of EPDS above or equal to 13 were regarded as postpartum depression. Thirty-five parturients with postpartum depression were classified as the depression group, and the remaining 45 were classified as the control group. The se- rum levels of PRL, P and E2 were measured simultaneously. Results The depression group was significantly higher than the control group after postpartum 5 d, 42 d in serum PRL, with statistical significant difference between the two groups （P〈0.05）. There was no significant difference in E2 between the depression group and the control group （P〉 0.05）. The depression group was significantly lower than the control group after postpartum 5 d, 42 d in E2 and P, with statistical significant difference between the two groups （P〈0.05）. Conclusion After delivery of the placenta, there is close relationships between the serum levels of prolactin, estradiol and progesterone with postpartum depression.