青春期PCOS患者与正常女性焦虑抑郁状态差异分析

Analysis of anxiety and depression in adolescent PCOS patients and normal women

目的 探讨青春期PCOS患者与同龄正常青春期女性的焦虑抑郁水平差异,探索可能的心理影响因素。方法 收集2015年10月至2018年1月来我院妇科门诊就诊的76例青春期PCOS患者作为PCOS组,选择同期来我院常规体检的76例相同年龄段的正常青春期女性为对照组。比较两组患者的空腹血糖(FG)、标准化口服75g葡萄糖耐受试验的餐后2h血糖(GLU-2)、空腹胰岛素(FINS)、甘油三酯(TG)、FSH、LH、E2和胰岛素抵抗指数(HOMA-IR)等实验室指标,及抑郁症患者健康问卷(PHQ-9)和广泛性焦虑筛查量表(GAD-7)评分情况。结果 两组患者的FSH、E2、FG、总胆固醇(TC)、高密度脂蛋白(HDL)、TG水平比较均无显著性差异(P>0.05);PCOS组的总睾酮(T)、脱氢表雄酮硫酸盐(DHEA-S)、HOMA-IR、LH、GLU-2及FINS水平显著高于对照组(P<0.05)。PCOS组患者的PHQ-9与GAD-7两项得分亦显著高于对照组[分别为(11.9±3.3)vs.(2.2±3.9)分和(14.9±3.7)vs.(6.5±3.9)分](P<0.05)。结论 青春期PCOS患者比正常青春期女性更容易出现情绪障碍,这种情绪障碍可能跟PCOS的某些临床特征有关,提示临床上对青春期PCOS患者的常规评估也应包括对情绪障碍的评估。

Objective : To explore the difference of anxiety and depression levels between adolescent PCOS patients and women with the same age and normal BMI,and explore possible psychological factors. Methods : The 76 adolescent PCOS patients were selected in our hospital from October 2015 to January 2018 as PCOS group,and 76 normal women with age and BMI,who came to our hospital for physical examination were matched as control group. All the patients completed the Depression Patient Health Questionnaire(PHQ-9) and the General Anxiety Screening Scale(GAD-7). The fasting blood glucose(FG),postprandial 2 hours blood glucose(GLU-2),fasting insulin(FINS),triglycerides(TG),FSH,LH,E 2,and insulin in a standardized oral 75 g glucose tolerance test laboratory indicators such as insulin resistance index(HOMA-IR),and the scores of PHQ-9 and GAD-7 were compared between the two groups. Results : There were no significant differences in FSH,E 2,FG,total cholesterol(TC),high-density lipoprotein(HDL) and TG levels between the two groups( P >0.05). The total testosterone(T),dehydroepiandrosterone(DHEA-S),HOMA-IR,LH,postprandial GLU-2 and FINS were significantly higher than those in the control group( P <0.05). The scores of PHQ-9 and GAD-7 in the PCOS group[(11.9±3.3) vs.(2.2 ±3.9) and(14.9±3.7) vs.(6.5±3.9),respectively] were also significantly higher than those in the control group( P <0.05). Conclusions : Adolescent PCOS patients are easier to suffer emotional disorders than normal adolescents. These emotional disorders may be related to some clinical features of PCOS. It is suggested that the clinical assessment of adolescent PCOS patients should also include an assessment of mood disorders.