产后抑郁产妇血清超敏C-反应蛋白、雌孕激素检测的临床价值及影响因素分析

Analysis on clinical value and influencing factors of serum high-sensitive C-reactive protein,estrogen,and progesterone in postpartum women with depression

目的探讨产后抑郁产妇血清超敏C-反应蛋白(hs-CRP)、雌孕激素检测的临床价值及产后抑郁的影响因素,旨在减少和避免产后抑郁的发生。方法回顾性分析2017年3月-2019年1月在温州康宁医院分娩160例的产妇临床资料,根据爱丁堡产后抑郁量表(EPDS)评分将产妇分为产后抑郁组31例和无产后抑郁组129例,采用酶联免疫吸附法检测两组产妇的雌二醇(E2)、孕酮(P)、hs-CRP水平,采用Pearson相关性分析hs-CRP、E2、P与EPDS评分的相关性,分析不同特征的产妇产后抑郁发生情况,采用多元Logistic回归分析产妇产后抑郁的独立相关影响因素。结果产后抑郁组产妇分娩后2 d、7 d E2低于无产后抑郁组产妇,P、hs-CRP、EPDS评分高于无产后抑郁组产妇,差异均有统计学意义(P<0.05)。P、hs-CRP与EPDS评分均呈正相关,E2与EPDS评分呈负相关(P<0.05)。单因素分析结果显示年龄、分娩方式与产妇产后抑郁无关(P>0.05);文化程度、产次、新生儿性别、喂养方式、家庭年收入、夫妻关系与产妇产后抑郁有关(P<0.05)。多元Logistic回归分析结果显示文化程度、产次、喂养方式、夫妻关系、家庭年收入均是产妇产后抑郁发生的独立相关影响因素(P<0.05)。结论产后抑郁产妇hs-CRP、P、E2均存在异常表达,且与产后抑郁严重程度密切相关;文化程度、产次、喂养方式、夫妻关系、家庭年收入均是产妇产后抑郁发生的独立相关影响因素。

Objective To explore the clinical value and influencing factors of serum high-sensitive C-reactive protein(hs-CRP),estrogen,and progesterone in postpartum women with depression,reduce and avoid postpartum depression.Methods The clinical data of 160 postpartum women giving birth to their babies in Wenzhou Kangning Hospital from March 2017 to January 2019 were retrospectively analyzed.According to Edinburgh Postpartum Depression Scale(EPDS)score,the postpartum women were divided into postpartum depression group(31 women)and non-postpartum depression group(129 women).ELISA was used to detect the levels of estradiol(E2),progesterone(P),and hs-CRP in the two groups.Pearson correlation analysis was used to analyze the correlations between hs-CRP,E2,P and EPDS score.The incidence rates of postpartum depression in the women with different characteristics were analyzed.Multivariate Logistic regression analysis was used to analyze the independent influencing factors of postpartum depression.Results The levels of E2 at 2 and 7 days after delivery in postpartum depression group were statistically significantly lower than those in non-postpartum depression group,the levels of P and hs-CRP,EPDS scores at 2 and 7 days after delivery in postpartum depression group were statistically significantly higher than those in non-postpartum depression group(P<0.05).P and hs-CRP were positively correlated with EPDS score,while E2 was negatively correlated with EPDS score(P<0.05).Univariate analysis showed that age and delivery mode were not correlated with postpartum depression(P>0.05).Educational level,parity,sex of newborn,feeding mode,annual family income,marital relationship were correlated with postpartum depression(P<0.05).Multivariate Logistic regression analysis showed that educational level,parity,feeding mode,marital relationship,annual family income were independent influencing factors of postpartum depression(P<0.05).Conclusion The expression levels of hs-CRP,P,and E2 in the women with postpartum depression are abnormal,which are closely correlated with the severity of postpartum depression.Educational level,parity,feeding mode,marital relationship,annual family income are independent influencing factors of postpartum depression.