抑郁症患者治疗前后性激素水平的变化及与临床特征的关系

目的　探讨抑郁症患者治疗前后性激素水平的变化及其与临床特征的关系。方法　用酶联免疫吸附法测定 30例抑郁症患者治疗前、后血清雌二醇、孕酮、睾酮水平 ,并与 30名正常对照比较 ,同时作相关分析。结果　男性和女性抑郁症患者血清雌二醇水平均显著低于正常对照 (t=- 4 2 4 5 ,P <0 0 1;t =- 4 342 ,P <0 0 1) ,雌二醇水平与HAMD分和HAMA分呈负相关 (r =- 0 5 0 4 ,P <0 0 1;r =- 0 389,P <0 0 5 )。男性患者的睾酮水平显著低于正常对照 (t=- 2 319,P <0 0 5 ) ,而女性患者的睾酮水平与正常对照无显著差异 (t=0 5 6 9,P >0 0 5 )。抑郁症患者的孕酮水平无显著变化 (P >0 0 5 )。帕罗西汀治疗后 ,雌二醇水平显著升高 (t =- 4 335 ,P <0 0 1;t =- 4 0 14 ,P <0 0 1) ,但仍低于正常对照 (t=- 2 4 99,P <0 0 5 ;t=- 2 4 4 6 ,P <0 0 5 ) ,男性患者的睾酮水平恢复正常 ,孕酮水平及女性患者的睾酮水平治疗前后无显著变化 (P >0 0 5 )。治疗有效者比疗效不佳者的雌二醇水平显著增高 (t=4 12 7,P <0 0 1)。结论　抑郁症患者存在性激素水平改变 ,治疗后性激素水平仍未完全恢复正常 ,患者病前雌二醇水平与HAMD和HAMA分呈负相关 ,与抗抑郁疗效呈正相关。

The change of sexual hormone in depressive patients before and after treatment and its relationship with their clinical features

Objective: To detect the change of sexual hormone in depressive patients and its relationship with their clinical features. Methods: The serum estradiol, progesterone and testosterone levels were measured with enzyme linked immunosorbent assay in 30 depression patients before and after treatment, compared with 30 normal controls. Correlation analysis was conducted at the mean time. Results: The estradiol levels of male and female patients before treatment were significantly lower than that of normal controls ( t= -4 245, P<0 01; t=-4 342,P <0 01), and they showed negative correlation with the scores of HAMD ( r=-0 504,P <0 01) and HAMA ( r=-0 389,P <0 05). The testosterone levels of male patients was significantly lower than that of the controls, but it was not the case in female patients ( t=0 569,P> 0 05). After paroxetine treatment, the estradiol levels increased significantly ( t=-4 335,P<0 01;t=-4 014,P <0 01), but they were lower than that of control still ( t=-2 499,P<0 05;t=-2 446,P <0 05), and the testosterone levels of male patients resumed normal. There were no change in progesterone and testosterone levels of female patients both pretreatment and after treatment compared with control ( P> 0 05). The estradiol levels of patients who had clinical effectiveness were significantly higher than that of patients without satisafactory effectiveness. Conclusion: The alterations of sexual hormone were found in depressive patients, but they were not resume normal after treatment. Serum estadiol levels of depressive patients before treatment were negatively correlated to HAMD and HAMA scores, which were positively correlated to the anti depressive treatment.