帕罗西汀对首发抑郁症患者治疗前后性激素水平变化及与疗效的关系

目的 探索抑郁症患者性激素水平和治疗后的变化与治疗效果的关系.方法 收集抑郁症患者60例作为观察组,健康体检的志愿者60例作为对照组,检测患者治疗前后的血清雌二醇、孕酮及睾酮的水平,用汉密尔顿抑郁量表(HAMD)对抑郁患者进行评分,分析抑郁程度与性激素水平之间的相关性.结果 治疗前观察组男性和女性的血清雌二醇水平均低于对照组,男性的孕酮及睾酮水平低于对照组,差异均有统计学意义(P<0.05),女性的孕酮和睾酮水平与对照组差异无统计学意义(P>0.05);治疗后男性和女性患者的血清雌二醇水平高于治疗前,差异有统计学意义(P<0.05),男性患者的睾酮水平高于治疗前,差异有统计学意义(P<0.05),而男性和女性患者孕酮水平及女性患者的睾酮水平与治疗前的差异无统计学意义(P>0.05);治疗后观察组男性和女性患者的孕酮及睾酮水平与对照组之间的差异均无统计学意义(P>0.05),观察组女性患者的血清雌二醇水平与对照组之间的差异无统计学意义(P>0.05),观察组男性患者血清雌二醇水平低于对照组,差异有统计学意义(P<0.05);HAMD减分率与血清雌二醇水平之间呈正相关(r=0.561,P=0.007);而与血清孕酮及睾酮之间无相关性(P>0.05).结论 抑郁症患者血清雌二醇与抑郁症之间呈负相关,睾酮水平的变化可能仅是男性抑郁症患者的一个危险因素.

Changes of sex hormone levels before and after treatment of first episode depression by paroxetineand its relationship with efficacy

Objective To explore the relationship between the changes of sex hormone level before and after treatment and the treatment effect in depression patients. Methods A total of 60 patients with de-pression were selected into the observation group, and 60 healthy volunteers who had physical examination in our hospital were recruited into the control group. The serum estradiol, progesterone, testosterone levels of patients were monitored before and after treatment, at the same time, the depression patients were assessed by the Ham-ilton Depression Scale (HAMD), and the correlation between depression and sex hormone levels was analyzed. Results Before the treatment, the serum estradiol levels of male and female patients in the depression group were both lower than that in control group, and the progesterone and testosterone levels in men were lower than in the control group, with statistical difference (P<0.05). On the contrary, there was no significant difference of female progesterone and testosterone levels between the observation group and the control group (P>0.05). The serum estradiol of male and female patients and the testosterone of male patients were all higher after the treatment, and the difference was statistically significant (P<0.05). The progesterone levels of both genders and female testosterone showed no statistical difference after the treatment (P>0.05). There was no statistical dif-ference of progesterone and testosterone of both genders after treatement between the two groups (P>0.05). The serum estradiol of female patients had no difference between the two groups after treatment (P>0.05), while the serum estradiol of male patients in the observation group were significantly lower than that in the control group after the treatment (P<0.05). HAMD reduction rate was positively related to the serum estradiol level (r=0.561, P=0.007), and had no correlation with serum progesterone and testosterone (P>0.05). Conclusions There is a negative correlation between serum estradiol level of depression patients and the depression. The changes of tes-tosterone level may simply be a risk factor for male patients with depression.