围绝经期抑郁症与雌激素及单胺类递质水平的相关性研究

Correlation study on perimenopausal depression with estrogen and monoamine neurotransmitter

目的探讨围绝经期抑郁症与雌激素及单胺类递质水平的相关性,以分析围绝经期抑郁症的可能发病机制。方法选择2012年10月至2014年1月浙江省武义县妇幼保健院妇产科收治的围绝经期抑郁症患者53例,设为观察组;另选择同期体检的健康围绝经期妇女56例作为对照组。用汉密顿抑郁量表(HAMD)评价受试者抑郁状况,电化学发光免疫法测定两组血清雌二醇(E_2)和卵泡刺激素(FSH)水平,高效液相-电化学法测定两组血浆5-羟色胺(5-HT)和去甲肾上腺素(NE)水平。用pearson相关分析对HAMD总分与E_2、FSH、5-HT和NE进行相关性检测。结果观察组E_2显著低于对照组(t=8.616,P<0.05),FSH显著高于对照组(t=6.668,P<0.05)。观察组5-HT显著低于对照组(t=9.030,P<0.05),NE显著高于对照组(t=4.798,P<0.05)。Pearson相关分析显示,HAMD总分与E_2呈显著负相关(r=-0.547,P<0.05),与FSH呈显著正相关(r=0.488,P<0.05),与5-HT呈显著负相关(r=-0.387,P<0.05),与NE呈显著正相关(r=0.294,P<0.05)。结论雌激素及单胺类递质可能参与了围绝经期抑郁症的发病,并能提示病情的严重程度。

Objective To explore the correlation among perimenopausal depression , estrogen and monoamine neurotransmitter , so as to analyze the possible pathogenesis of perimenopausal depression . Methods From October 2012 to January 2014 53 patients with perimenopausal depression admitted in gynecology and obstetrics department of Maternal and Child Health Hospital of Wuyi County were selected in observation group .Another 56 healthy perimenopausal women as the same period were selected in control group .Hamilton depression scale （ HAMD） was used to evaluate the depression status .Electrochemiluminescence immunoassay was adopted to detect the levels of estradiol （E2） and follicular hormone （FSH）, and High Performance Liquid Chromatography （HPLC） was used to detect the level of plasma serotonin （5-HT） and norepinephrine （ NE）.The correlation between HAMD scores and E 2 , FSH, 5-HT and NE was analyzed by pearson correlation analysis .Results The level of E 2 was significantly lower but FSH was significantly higher in the observation group than in the control group （t value was 8.616 and 6.668, respectively, both P 〈0.05）.In the observation group 5-HT was significantly lower but NE was significantly higher than in the control group （t value was 9.030 and 4.798, respectively, both P〈0.05）. Pearson correlation analysis showed that total scores of HAMD were negatively correlated with E 2 and 5-HT （ r value was -0.547 and-0.387, respectively, both P 〈0.05）, and that they were positively correlated with FSH and NE （r value was 0.488 and 0.294, respectively, both P〈0.05）.Conclusion Estrogen and monoamine neurotransmitters may be involved in the onset of perimenopausal depression, and they can reflect the severity of the illness in a certain extent .