老年期女性脑卒中后抑郁患者下丘脑-垂体-性腺轴功能变化的研究  

Study on the functional changes of hypothalamus-pituitary-gonad axis in senility women with post-stroke depression

作　　者：熊光润 赵凌云 毛建平 

机构地区：[1]湖北宜昌市第二人民医院神经内科,443000 [2]湖北宜昌市第二人民医院放射科,443000

出　　处：《神经疾病与精神卫生》2007年第3期180-182,共3页Journal of Neuroscience and Mental Health

基　　金：湖北省宜昌市科技发展计划项目(A05302-16)

摘　　要：目的探讨老年期女性脑卒中后抑郁下丘脑-垂体-性腺轴功能变化。方法选择102例老年期女性病程4周内脑卒中患者按中国精神疾病分类方案与诊断标准第二版(CCMD-2-R)、DSM-IV诊断标准确定脑卒中后抑郁(PSD),分为非PSD组、PSD组,并设健康老年对照组,均于1周、2周、4周采用放射免疫法测定血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P),HAMD、抑郁自评量表(SDS)评分均在病程1周、2周、4周、与性激素测定采血同日进行。结果PSD组FSH、LH在1周、2周、4周呈逐渐上升;PSD组与对照组FSH、LH在1周、2周、4周比较有极显著性差异(P<0.01);PSD组与对照组E2、P比较均无显著性差异(P>0.05)。PSD组FSH、LH动态变化与HAMD、SDS评分呈正相关(P<0.05),E2、P与HAMD、SDS评分无相关。结论PSD患者存在下丘脑-垂体-性腺轴功能异常;动态测定血清性激素变化可及早判别PSD。Objective To study the functional changes of hypothalamus- pituitary-gonad axis （HPG） in senility women with post-stroke depression （PSD）. Methods 102 senility women with 4weeks post-stroke depression were divided into non-PSD group and PSD group, healthy senility group set as control. The diagnosis of PSD was made with American Psychiatric Association Diagnostic and Statistical Manual Disorders-Fourth Edition （DSM-IV） and the Chinese Classification of Mental Disorders, Second Edition, Revised （CCMD- 2- R）. PSD group was assessed with 17-item Hamilton. Depression Rating scales（HAMD） and identified as mild,moderate or severe depression. The serum levels of prolactin （PRL）, luteinizing hormone（LH）, follicle stimulating hormone（FSH）, estradiol （E2） and progesterone（P） were dynamicly tested by radioimmunoassay（RIA） in non-PSD, PSD and control group. Results The serum levels of PRL, LH and FSH tended to increase in PSD group （P 〈 0.05） ; serum levels of PRL, LH and FSH were significantly higher in PSD group than in control group （P 0.01） ;There was no significant difference between PSD group and control group in serum levels of E2 and P （P 〉 0.05） ; The serum levels of PRL, LH and FSH have a positive correlation to the average score of HAMD and SDS in PSD group （P 〈 0.05） , but the serum levels of E2 and P have no correlation to the average score of HAMD and Self-rating Depression Scale（SDS）in PSD group （P 〉 0.05） . Conclusions There were dysfunction of HPG and disorders of PRL in patients of senility women with post-stroke depression. PSD may be early diagnosed by dynamical testing PRL, LH, FSH, E2 and P.

关 键 词：老年期脑卒中后抑郁 下丘脑-垂体-性腺轴 性激素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]