多囊卵巢综合征合并不孕症患者性激素和主要单胺类神经递质与抑郁情绪的关联性

Study on sex hormones,monoamine neurotransmitters,and depressive mood of infertility patients with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)合并不孕症患者性激素、主要单胺类神经递质及抑郁情绪三者之间的关联性。方法选取PCOS合并不孕症患者77名作为病例组,非PCOS不孕症患者77名作为对照组;采用流调中心用抑郁量表(CES-D)判断两组对象的抑郁症状及其严重程度,荧光免疫法测定两组对象血清中体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、总睾酮(TSTO)、催乳素(PRL)及孕酮(PRGE)等与生育相关的6项性激素水平,酶联免疫法测定两组对象的多巴胺(DA)、5-羟色胺(5-HT);应用t检验、卡方检验、相关分析等方法分析病例组和对照组性激素6项、DA和5-HT神经递质、抑郁情绪的差异及其三者之间的关联性。结果病例组抑郁症状阳性检出率高于对照组(P<0.05),总体调查对象的抑郁症发生率为35.06%,病例组CES-D得分高于对照组(P<0.05);病例组血清中LH、E2、TSTO水平高于对照组,FSH、DA、5-HT水平低于对照组(P<0.05);PCOS不孕症抑郁组PRGE、DA水平均低于PCOS不孕症非抑郁组,CES-D得分与LH水平、FSH水平、TSTO水平呈正相关(P<0.05),与DA、5-HT水平呈负相关(P<0.05);除FSH水平之外,其他5项性激素水平均与DA、5-HT水平呈负相关(P<0.05)。结论PCOS伴不孕症患者抑郁症状检出率较非PCOS不孕症患者高,抑郁情绪较严重;性激素6项水平与DA、5-HT水平相互影响,也可能是影响PCOS伴不孕症患者抑郁情绪的原因。

Objective To explore the correlation between sex hormones, major monoamine neurotransmitters and depression in infertility patients with polycystic ovary syndrome( PCOS).Methods Seventy-seven PCOS patients with infertility were selected as the case group,77 infertility patients as the control group. The depression degree of the two groups was judged by CES-D,the sex hormones in the serum of the two groups were measured by fluorescence immunoassay, and the levels of dopamine and serotonin in the two groups were measured by enzyme-linked immunosorbent assay;to analyze the relationship among sex hormones, major monoamine neurotransmitters, and depression.Results The detection rate of depressive symptoms in the case group was higher than that in the control group(P< 0. 05);the CES-D score of the case group was higher than that of the norm and control groups(P< 0. 05);the serum levels of LH, E2, and TSTO in the case group were higher than those in the control group, and the serum levels of FSH, DA, and 5-HT in the case group were lower than those in the control group(P< 0. 05);the levels of PRGE and DA in PCOS infertility depression group were lower than those in PCOS infertility non-depression group;CES-D score was positively correlated with LH, FSH, and TSTO, and negatively correlated with DA and 5-HT(P< 0. 05);except FSH, the other five sex hormone were negatively correlated with DA and 5-HT levels(P< 0. 05).Conclusion The incidence of depression in PCOS patients with infertility is high, and the depression is more serious;the levels of sex hormones and major monoamine neurotransmitters interact, and affect the depression of PCOS patients with infertility.