性激素水平与帕金森病患者抑郁和焦虑症状的相关分析  

Correlation analysis of sex hormone levels with depression and anxiety in Parkinson's disease

作　　者：任宁[1] 朱虹 胡静仪[3] 陈荣杰[1] 徐小林[1] REN Ning;ZHU Hong;HU Jing-yi;CHEN Rong-jie;XU Xiao-lin(Department of Neurology, Tianjin Huanhu Hospital, Tianfin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin 300350, China;Department of Clinical Laboratory, Tianjin Huanhu Hospital, Tianjin 300350, China)

机构地区：[1]天津市环湖医院神经内科天津市脑血管与神经变性重点实验室,300350 [2]天津市海河医院神经内科,300350 [3]天津市环湖医院检验科,300350

出　　处：《中国现代神经疾病杂志》2018年第4期266-271,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市卫生局科技基金资助项目(项目编号：2012KR11)

摘　　要：目的探讨帕金森病患者血清性激素水平与抑郁和焦虑等帕金森病非运动症状的相关性。方法共46例帕金森病患者(男性27例,女性19例)均于停用抗帕金森病药物12h后空腹采集肘静脉血,电化学发光法检测血清雌二醇、孕酮和睾酮水平,汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评价抑郁和焦虑症状。结果 46例患者中14例(30.43%)诊断为可能的抑郁症(HAMD评分8~19分),5例(10.87%)诊断为确定的抑郁症(HAMD评分≥20分);9例(19.57%)诊断为可能的焦虑症(HAMA评分7~13分),7例(15.22%)诊断为确定的焦虑症(HAMA评分≥14分)。女性帕金森病患者体重指数高于男性[(26.93±1.29)kg/m2对(23.99±1.51)kg/m2;t=6.872,P=0.000],血清雌二醇[(46.29±17.87)pmol/L对(129.64±32.34)pmol/L;t=10.080,P=0.000]、孕酮[0.99(0.67,1.18)nmol/L对1.30(0.86,2.04)nmol/L;Z=-2.722,P=0.006]和睾酮[(0.38±0.17)nmol/L对(13.52±5.41)nmol/L;t=10.538,P=0.000]均低于男性。女性帕金森病患者体重指数与HAMA评分呈负相关(r=-0.591,P=0.020),血清雌二醇水平与HAMD评分(r=-0.558,P=0.031)和HAMA评分(r=-0.675,P=0.006)呈负相关,血清睾酮水平与HAMA评分呈正相关(r=0.674,P=0.006);男性帕金森病患者仅血清睾酮水平与HAMD评分(r=-0.450,P=0.031)和HAMA评分(r=-0.507,P=0.013)呈负相关。结论帕金森病患者抑郁和焦虑等非运动症状常见,女性患者血清雌二醇水平越低、抑郁症状越严重,体重指数和血清雌二醇水平越低、血清睾酮水平越高、焦虑症状越严重;男性患者血清睾酮水平越低、抑郁和焦虑症状越严重。故性激素替代治疗可能成为改善帕金森病患者抑郁和焦虑症状的方法之一。Objective To investigate the correlation of sex hormone levels with depression andanxiety in Parkinson＇s disease（PD）. Methods A total of 46 PD patients（27 male and 19 female） wereenrolled in this study. After withdrawing anti-PD drugs for 12 h, their fasting blood was taken from cubitalvein. Electrochemiluminescence（ECL） assay was used to detect serum estradiol, progesterone andtestosterone. Hamilton Depression Rating Scalseu l（tHs AMD） and Hamilton Anxiety Rating Scale（HAMA） wereused to evaluate depression and anxiety. ReFourteen cases（30.43%） were diagnosed as possibledepression（HAMD score 8-19）, and 5 cases（10.87%） were diagnosed as definite depression（HAMDscore ≥ 20）. Nine cases（19.57%） were diagnosed as possible anxiety（HAMA score 7-13）, and 7 cases（15.22%） were diagnosed as definite anxiety（HAMA score ≥ 14）. The body mass index（BMI） of female PDpatients was significantly higher than that of male [（26.93 ± 1.29） kg/m^2 vs.（23.99 ± 1.51） kg/m^2; t = 6.872,P = 0.000]. The serum estradiol [（46.29 ± 17.87） pmol/L vs.（129.64 ± 32.34） pmol/L; t = 10.080, P = 0.000],progesterone [0.99（0.67, 1.18） nmol/L vs. 1.30（0.86, 2.04） nmol/L; Z =-2.722, P = 0.006] and testosterone[（0.38 ± 0.17） nmol/L vs.（13.52 ± 5.41） nmol/L; t = 10.538, P = 0.000] in female PD patients weresignificantly lower than those in male patients. In female PD patients, BMI was negatively correlated withHAMA score（r =-0.591, P = 0.020）, serum estradiol level was negatively correlated with HAMD score（r =-0.558, P = 0.031） and HAMA score（r =-0.675, P = 0.006）, serum testosterone level was positively correlatedwith HAMA score（r = 0.674, P = 0.006）. In male PD patients, only serum testosterone level was negativelycorrelated with HAMD score（r =-0.450, P = 0.031） and HAMA score（r ons =-0.507, P Conclusi= 0.013）.Non-motor symptoms, such as depression and anxiety, are very common in PD. The lowerserum estradiol level, the more severe de

关 键 词：帕金森病 性腺甾类激素 抑郁 焦虑 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R749.72[医药卫生—临床医学]