绝经后抑郁症患者治疗前后性激素水平与临床疗效的相关性研究

目的 探讨绝经后抑郁症患者治疗前后性激素水平的变化及其与预后的相关性.方法 将30例绝经后抑郁症患者设为研究组,30名绝经后正常女性设为对照组;研究组均口服帕罗西汀治疗6周,于治疗前后检测性激素水平,同时采用汉密顿抑郁量表评定临床疗效;对照组于入组时检测性激素水平.结果 治疗后研究组促黄体生成素、促卵泡刺激素水平均较治疗前显著下降,雌二醇水平显著升高(P＜0.05).研究组治疗前促黄体生成素、促卵泡刺激素水平均显著高于对照组,雌二醇水平显著低于对照组(P＜0.01);治疗后促卵泡刺激素水平仍显著高于对照组(P＜0.05),雌二醇水平仍显著低于对照组(P＜0.05).研究组治疗有效者治疗前雌二醇水平显著高于治疗无效者(P＜0.01).研究组治疗前雌二醇水平与汉密顿抑郁量表评分呈显著负相关(R=-0.67,P＜0.01),治疗后与汉密顿抑郁量表减分率呈显著正相关(R=0.63,P＜0.01).结论 绝经后抑郁症患者治疗前后性激素水平有不同程度的变化,雌二醇、促卵泡刺激素、促黄体生成素水平的改变可能影响抑郁症状;其中雌二醇水平的变化可作为预测患者预后的一项指标.

The correlation study of pre- and post-treatment sex hormone levels and efficacy in postmenopausal depression patients

Objective To explore the changes of pre- and post-treatment sex hormone levels and its correlation to prognosis in postmenopausal depression（PMD） patients. Methods Thirty PMD patients were assigned to research group and 30 postmenopausal normal women to control group; research group took orally paroxetine for 6 weeks, sex hormone levels were detected and efficacies assessed with the Hamilton Depression Seale（HAMD） before and after treatment; sex hormone levels were detected before treatment in control group. Results After treatment luteinizing hormone and flitropin level significantly lowered and estradiol heightened compared with pretreatment in research group （P〈0.05）. Pre-treatment luteinizing hormone and flitropin level were significantly higher and estradiol lower in research than in control group （P〈0. 01）; post treatment flitropin level was still significantly higher （P〈0. 05） and estradiol lower （P〈0.05） in research than in control group. Pre-treatment estradiol level was significantly higher in responders than in non-responders in research group （P〈0.01）. In research group, pre treatment estradiol level was significantly negatively related to the HAMD score （R=-0.67, P〈0.01）, post-treatment es tradiol level positively to the HAMD score-reducing rate （R=0.63, P〈0. 01）. Conclusion Pre- and post- treatment sex hormone levels in PMD patients had various degrees of changes, the changes of estradiol, flitropin and luteinizing hormone levels possibly influence depressive symptoms; the change of estradiol level can be used as an index predicting patients＇ prognosis.