围产期不同时期性激素及炎性因子水平变化对抑郁状态的影响

The influence of the changes of sex hormones and inflammatory factor at different perinatal periods on depression

目的:探讨围产期不同时点性激素及炎性因子水平对围产期抑郁(PND)状态的影响。方法:对整个孕期都在贵州医科大学附属医院产科门诊进行保健的孕妇,分别在孕早期(11~12周末)、孕中期(24~27周末)、孕晚期(37周~分娩前)、产后(42~48 h)进行跟踪,采用EPDS评分,分为PND组和非PND组,用ELISA检测不同时期血清性激素和炎性因子的水平,比较两组间的差异。结果:PND组和非PND组性激素及炎性因子在4个时期差异均有统计学意义(P<0.05)。各指标水平随时间不断波动变化,在各个时期差异均有统计学意义(P<0.05)。孕晚期PND组E2水平高于非PND组(P<0.05),VEGF水平和E2水平呈负相关(r=-0.353),PLGF水平和E2水平呈正相关(r=-0.659)。结论:性激素与炎性因子水平在围产期不同时期存在波动,对PND的发生可能有影响,孕晚期E2水平越高,孕晚期抑郁发生的可能越大。

Objective:To investigate the influence of the changes of sex hormones and inflammatory factor in different perinatal periods on perinatal depression(PND).Methods:The whole gestations of the pregnant women of Obstetrics Department of the Affiliated Hospital of Guizhou Medical University were tracked and the sex hormones and inflammatory factor levels of Serum were detected by ELISA at the first trimester(11-12weeks),the second trimester(24-27 weeks),the third trimester(37weeks-parturition)and the postpartum period(42-48 h).The women were divided into the PND group and non-PND group by EPDS.The changes of sex hormones and inflammatory factor levels at different time were compared between the two groups(P<0.05).Results:There were significant differences for sex hormones and inflammatory factor levels at different perinatal periods between the two groups(P<0.05).Each index fluctuated over the time,and it exited differences in different periods(P<0.05).E2 level in the PND group was higher than that in the non-PND group at the third trimester(37weeks-parturition)(P<0.05),VEGF levels and E2 levels were negatively correlated(r=-0.353),while PLGF levels and E2 levels were positively correlated(r=-0.659).Conclusion:The fluctuation of sex hormones and inflammatory factor at different perinatal periods may have an effect on the occurrence of PND.The more E2 level,the higher risk of PND is likely to appear in the third trimester(37weeks-parturition).