血清炎症细胞因子和促甲状腺激素水平变化与产后抑郁症病情严重程度的相关性分析

目的探讨血清炎症细胞因子和促甲状腺激素(TSH)水平变化与产后抑郁症病情严重程度的相关性,为临床诊治提供依据。方法选取2018年3月-2019年5月温州市第七人民医院收治的经临床确诊的产后抑郁症患者107例,并选择同期96例非产后抑郁症的产妇作为正常对照组,检测两组受检者的血清白介素-1β(IL-1β)、白介素-6 (IL-6)、超敏C反应蛋白(hs-CRP)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)及TSH水平。采用爱丁堡产后抑郁量表(EPDS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对所有受检者进行焦虑和抑郁评价和比较,分析产后抑郁症患者EPDS评分与实验室检测指标之间的相关性。结果产后抑郁症组患者的EPDS评分、SAS评分及SDS评分均显著高于正常对照组,差异有统计学意义(均P<0. 05);产后抑郁症组产妇的血清IL-1β、IL-6、hs-CRP均显著高于正常对照组,差异有统计学意义(均P<0. 05)。产后抑郁症组产妇的TSH水平显著低于正常对照组,两组比较差异有统计学意义(P<0. 05);两组血清T3及T4水平比较差异无统计学意义(均P>0. 05)。产后抑郁症组患者的EPDS评分与血清IL-6及hs-CRP水平呈正相关(r=0. 603、0. 579,均P<0. 05),与血清TSH水平呈负相关(r=-0. 576,P <0. 05),而与血清T3、T4及IL-1β水平未见显著相关性(r=-0. 120、-0. 209、0. 107,均P>0. 05)。结论产后抑郁症患者的血清IL-1β、IL-6、hs-CRP水平较非产后抑郁症者显著升高,TSH水平显著降低;血清IL-6及hs-CRP水平越高,TSH水平越低,患者的抑郁程度越严重。

Analysis on the correlations between changes of serum inflammatory factors and thyroid stimulating hormone levels and severity of postpartum depression

Objective To explore the correlations between changes of serum inflammatory factors and thyroid stimulating hormone( TSH) levels and severity of postpartum depression,provide a basis for clinical diagnosis and treatment. Methods A total of 107 patients diagnosed as postpartum depression definitely in the Seventh People’s Hospital of Wenzhou from March 2018 to May 2019 were selected,96 women without postpartum depression during the same period were selected as normal control group. The levels of serum interleukin-1β( IL-1β),interleukin-6( IL-6),high-sensitivity C-reactive protein( hs-CRP),triiodothyronine( T3),tetraiodothyronine( T4),and TSH in the two groups were detected. Edinburgh Postnatal Depression Scale( EPDS),self-rating anxiety scale( SAS),and self-rating depression scale( SDS) were used to evaluate and compare anxiety and depression scores,the correlations between EPDS scores and laboratory indexes in patients with postpartum depression were analyzed. Results EPDS score,SAS score,and SDS score in postpartum depression group were statistically significantly higher than those in normal control group( P<0. 05). The levels of serum IL-1β,IL-6,and hs-CRP in postpartum depression group were statistically significantly higher than those in normal control group( P<0. 05). TSH level in postpartum depression group was statistically significantly lower than that in normal control group( P<0. 05). There was no statistically significant difference in the levels of serum T3 and T4 between the two groups( P>0. 05). In postpartum depression group,EPDS score was positively correlated with serum IL-6 and hs-CRP levels( r = 0. 603,0. 579,P<0. 05),EPDS score was negatively correlated with serum TSH level( r =-0. 576,P<0. 05),EPDS score was not significantly correlated with serum T3,T4,and IL-1β levels( r =-0. 120,-0. 209,0. 107,P>0. 05). Conclusion The levels of serum IL-1β,IL-6,and hs-CRP in patients with postpartum depression are significantly higher than those in patients without postpartum depression. TSH level in patients with postpartum depression is significantly lower than that in patients without postpartum depression. The higher the levels of serum IL-6 and hs-CRP are,the lower TSH level is,the severer the severity of depression is.