HBsAg阳性孕妇心理状况调查及其与皮质醇及性激素的关系

目的:探讨HBsAg阳性孕产妇的心理应激状况与皮质醇及性激素的关系。方法:随机抽取门诊或住院部就诊的HBsAg(+)妊娠晚期孕产妇67例。采用汉密尔顿抑郁量表(HRSD)、汉密尔顿焦虑量表(HAMA)及症状自评量表(SCL-90)评估HBsAg(+)孕产妇的心理状况;放免法测定血清雌二醇、孕酮及皮质醇水平。结果:抑郁与雌、孕激素水平均呈负相关(P<0.05);焦虑与皮质醇水平呈正相关;症状自评躯体化表现、强迫状态、抑郁和焦虑均与雌激素水平呈负相关(P<0.05);强迫症状和焦虑与皮质醇水平呈正相关。结论:乙肝孕产妇心理健康水平低下与激素水平存在相关性,血浆皮质醇及性激素水平是评估其心理状态的有效指标。

Relationship between psychological status survey and cortisol and sex hormones in pregnant women with positive HBsAg

Objective: To explore the relationship between psychological stress situation and cortisol and sex hormones in pregnant women with positive HBsAg. Methods: 67 pregnant women of late pregnancy with positive HBsAg were selected randomly from outpatient and inpatient department,their psychological status was evaluated by Hamilton Depression Scale ( HRSD) ,Hamilton Anxiety Scale ( HAMA) and Symptom Checklist 90 ( SCL 90 ) ; the serum levels of estradiol, progesterone and cortisol were detected by radioimmunoassay. Results: There was a negative correlation between anxiety and serum levels of estradiol and progesterone ( P < 0. 05) ; there was a positive correlation between anxiety and serum cortisol level; there was a negative correlation between somatization performance, obsessive state,depression,anxiety and serum estrogen level ( P < 0. 05) ; there was a positive correlation between obsessive state,anxiety and serum cortisol level. Conclusion: There is correlation between low level of psychological health in pregnant women with hepatitis B,the serum levels of cortisol and sex hormones are effective indexes in evaluating psychological status of pregnant women.