不孕不育患者的抑郁情绪与血清学指标水平变化异质性分析  

Heterogeneity analysis of depression, sexual life quality and biological level changes in infertile patients

作　　者：郭翠翠 杨德辉[1] 何玮[1] 李俊林[1] 张耀[1] 周静[2] Guo Cuicui;Yang Dehui;He Wei;Li Junlin;Zhang Yao;Zhou Jing(Center of Reproductive,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;Department of Psychosomatic Medicine,Leshan People′s Hospital,Leshan 614099,Sichuan,China)

机构地区：[1]绵阳市中心医院生殖中心,四川绵阳621000 [2]乐山市人民医院心身医学科,四川乐山614099

出　　处：《中国性科学》2019年第11期111-115,共5页Chinese Journal of Human Sexuality

基　　金：四川省卫生和计划生育委员会科研课题(17PJ386)

摘　　要：目的研究不孕不育患者抑郁情绪血清学指标水平(同型半胱氨酸水平、甲状腺激素)性别异质性,以便更好地治疗和预防不孕不育患者抑郁症的发生。方法选取2017年1月至2018年1月绵阳市中心医院和乐山市人民医院诊治的96例不孕不育患者作为研究对象,以抑郁自量表(self-rating depression scale,SDS)为基准,对患者的抑郁情绪进行评估。根据测评结果,将不孕不育伴有抑郁情绪的58例患者随机抽取38例设为观察组,将不孕不育不伴有抑郁情绪的38例患者设为对照组;同时,将观察组38例患者按照性别分为男性患者组(18人)和女性患者组(20人)。分别对观察组和对照组患者体内的同型半胱氨酸水平、甲状腺激素进行测定和比较分析。结果①观察组患者体内的同型半胱氨酸(homocysteine,Hcy)水平和诱导甲状腺产生甲状腺激素的超敏促甲状腺激素(thyroid stimulating hormone,TSH)高于对照组患者,其差异具有统计学意义(P<0.05)。②对于观察组患者而言,不同性别患者抑郁程度比较,其差异无统计学意义(P>0.05)。③观察组患者中,女性患者体内的Hcy、甲状腺素(thyroxine,T4)、三碘甲腺原氨酸(triiodothyronine,T3)均低于男性患者,而TSH则高于男性患者,其差异均具有统计学意义(均P<0.05)。④随着SDS指数的增高,观察组患者体内的Hcy、TSH均有一定程度的增加,三者之间呈正相关,且通过研究发现Hcy、TSH可以显著正向预测SDS评分。⑤通过对不孕不育患者性生活质量比较,观察组患者的性生活质量低于对照组患者,但差异无统计学意义(P>0.05)。结论观察组男女患者体内同型半胱氨酸水平、甲状腺激素存在差异,且与抑郁情绪相关,应当重视不孕不育患者的抑郁情绪和体内相关激素等生物水平的变化状况,对其可能存在的性别异质性问题进行研究。Objective To study the gender heterogeneity of serum levels of depression(homocysteine level,thyroid hormone)in infertile patients.Methods A total of 96 infertile patients diagnosed and treated in Mianyang Central Hospital and Leshan People′s Hospital from January 2017 to January 2018 were selected as subjects.The self-rating depression scale(SDS)was used as the benchmark.Evaluate the patient′s depression.According to the evaluation results,58 patients with infertility and depression were randomly enrolled in 38 cases,and 38 patients with infertility without depression were used as control group.At the same time,the observation group 38 patients were divided into male patient group(18 patients)and female patient group(20 patients)according to gender.The homocysteine levels and thyroid hormones in the observation group and the control group were measured and compared.Results①The levels of homocysteine(Hcy)and thyroid stimulating hormone(THH)in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).②For the observation group,there was no significant difference in the degree of depression between different gender patients(P>0.05).③In the observation group,Hcy,thyroxine(T4)and triiodothyronine(T3)were lower in female patients than in male patients,while TSH was higher than male patients.Statistical significance(all P<0.05).④With the increase of SDS index,the Hcy and TSH in the observation group increased to some extent,and there was a positive correlation between the three groups.It was found that Hcy and TSH can significantly predict the SDS score positively.⑤By comparing the quality of sexual life of infertile patients,the quality of life of the observation group was lower than that of the control group,but the difference was not statistically significant(P>0.05).Conclusions There are differences in homocysteine levels and thyroid hormones between male and female patients in the observation group,and they are related to depression.It

关 键 词：不孕不育 抑郁情绪 生物水平变化 异质性 性别 

分 类 号：R714[医药卫生—妇产科学]