围绝经期抑郁症与性激素的关系

目的 探讨围绝经期抑郁症及围绝经期不同阶段雌激素和雄激素水平的关系,并了解血管舒缩综合征与性激素的关系.方法 收集40例在围绝经期内首次出现中、重度抑郁症状的患者(病例组)和40例围绝经期健康对照者(对照组),依据月经状况将病例组和对照组分为病例绝经期组、病例绝经后期组、对照绝经期组和对照绝经后期组4个亚组,依据有无血管舒缩症状将所有入组者分为有血管症状组和无血管症状组2个亚组.采用电化学发光免疫法分别测定血清中雌二醇(E2)、睾酮(T)的水平,并对病例组进行汉密顿抑郁量表评分.结果 ①病例组E2水平显著低于对照组(P<0.01),与汉密顿抑郁评分呈负相关趋势(rs=-0.783, P<0.01);且无论是绝经期(P<0.05)还是绝经后期(P<0.01),E2水平都低于同阶段的健康对照组;②病例组T水平明显高于对照组(P<0.01),且病例绝经期亚组T水平也高于对照绝经期亚组(P<0.01),但绝经后期病例组与对照组T水平比较差异无统计学意义(P＞0.05);并且病例组T水平与汉密顿抑郁评分无相关性(rs=0.311, P＞0.05);③病例组与对照组E2/T比较差异有统计学意义(P<0.01);④有血管症状亚组与无血管症状亚组E2水平比较差异无统计学意义(P＞0.05),而T水平明显升高(P<0.01).结论 ①雌激素是围绝经期抑郁症的保护因素;②睾酮与围绝经期抑郁症关系尚不明确;③机体内激素间动态平衡被打破,激素间比例失衡也是抑郁症的危险因素;④围绝经期出现的血管舒缩症状与雌二醇水平下降无关,而可能与睾酮水平升高有关. Abstract： Objective To explore the correlations between serum estralio(E2),testosterone(T)levels and perimenopause depression.To find out relationships between sex hormones and vascular symptoms.Methods We collected 40 women with perimenopausal depression as case group and 40 healthy women as control group. All the subjects were assigned to six groups: menopausal transtion period case and control,postmenopausal case and control,subgroup with vascular symptoms and subgroup without vascular symptoms.Electrochemiluminescence immunoassay (ECLIA) was used to measure the levels of the serum E2 and T. Results ①The level of E2 in case group was significantly lower than that in control group(P<0.01),and had negative correlation with HAMD scales(P<0.01);In both the menopausal transition period and the postmenopause period, the level of E2 in case group was lower than that in the matched control group (P<0.05,P<0.01).②The level of T in case group was significantly higher than that in control group(P<0.01), and had the same finding between menopausal transition period'case and control(P<0.01),but had no significant difference between postmenopause'case and control (P＞0.05) .Furthermore, no association could be detected between the level of T and HAMD scales in case group(P＞0.05);③The E2/T in case group and control group had significant differences(P<0.01);④The level of T in subgroup with vascular symptoms was higher than that in subgroup without vascular symptoms(P<0.01),but the difference about E2 between the two subgroups was not statistically signifcant(P＞0.05). Conclusions ①The level of Serum E2 is a protective factor of depression;②What the real relationships between the T level and perimenopausal depression is uncertain;③The imbalance of the ratios of every sex hormones,and the dynamic equilibrium in human body being broken,can cause depression;④The higher level of serum T, not lower level of serum E2, may be related to vascular symptoms in perimenopause.

Relationship between perimenopausal women's depression and female hormone levels

Depression Perimenopausal Testosterone Estradiol Vascular symptoms