妊娠糖尿病孕妇产前抑郁发生情况及其与血清神经营养因子和炎性细胞因子水平的关系  

Incidence of prenatal depression in pregnant women with gestational diabetes mellitus and its relation with serum neurotrophic factors and inflammatory cytokines levels

作　　者：韩爽 温瀚英 李芳[3] 曹霞[4] 刘富国 麻莉 HAN Shuang;WEN Han-ying;LI Fang;CAO Xia;LIU Fu-guo;MA Li(Fengtai District Nanyuan Hospital,Beijing 100076,China;Beijing Fengtai Center for Disease Control and Prevention,Beijing 100071,China;Department of Pharmacy,,Fengtai District Maternal and Child Health Hospital,Beijing 100069,China;Department of Women′s Health Care,Fengtai District Maternal and Child Health Hospital,Beijing 100069,China;Department of Clinical Laboratory,Fengtai District Maternal and Child Health Hospital,Beijing 100069,China;Department of Obstetrics and Gynecology,PLA Rocket Force General Hospital,Beijing 100088,China)

机构地区：[1]北京市丰台区南苑医院,北京市100076 [2]北京市丰台区疾病预防控制中心,北京市100071 [3]北京市丰台区妇幼保健院药剂科,北京市100069 [4]北京市丰台区妇幼保健院妇保科,北京市100069 [5]北京市丰台区妇幼保健院检验科,北京市100069 [6]火箭军总医院妇产科,北京市100088

出　　处：《广西医学》2021年第14期1673-1676,1681,共5页Guangxi Medical Journal

基　　金：首都临床特色应用研究专项基金(Z171100001017228)。

摘　　要：目的探讨妊娠糖尿病(GDM)孕妇产前抑郁发生情况及其与血清神经营养因子和炎性细胞因子水平的关系。方法选择120例GDM孕妇(GDM组)和40例健康孕妇(对照组)为研究对象。采用患者健康问卷(PHQ-9)调查孕妇抑郁状况,并根据评分将GDM组分为正常组、轻度组、中度组、中重度组4个亚组。采用酶联免疫吸附法测定孕期30周时所有孕妇的血清星形胶质源性蛋白S100B、胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)、白细胞介素(IL)-1、IL-6、肿瘤坏死因子α(TNF-α)水平。比较GDM组和对照组孕妇的PHQ-9抑郁量表评分及产前抑郁发生情况、血清神经营养因子、炎症因子水平的差异,以及不同抑郁程度4个亚组GDM孕妇的血清神经营养因子水平、炎症因子水平的差异,并应用Spearman秩相关分析抑郁程度与血清神经营养因子、炎症因子水平的相关性。结果与对照组相比,GDM组PHQ-9抑郁量表评分和产前抑郁发生率均增高,血清S100B、IL-1、IL-6、TNF-α水平增加,而血清GDNF、BDNF水平降低(均P<0.05)。正常组、轻度组、中度组、中重度组GDM孕妇的血清S100B、IL-1、IL-6、TNF-α水平依次升高,差异均有统计学意义(均P<0.05);相关性分析显示,随着抑郁程度增加,GDM孕妇血清S100B、IL-1、IL-6、TNF-α水平升高,血清GDNF、BDNF水平降低(均P<0.05)。结论GDM患者产前抑郁发生率较高。S100B、IL-1、IL-6、TNF-α水平增加以及GDNF、BDNF水平降低可能与GDM患者产前抑郁的发生和严重程度均有关。Objective To explore the incidence of prenatal depression in pregnant women with gestational diabetes mellitus(GDM)and its relation with serum neurotrophic factors and inflammatory cytokines levels.Methods Totally 120 pregnant women with GDM(GDM group)and 40 healthy pregnant women(control group)were selected as subjects.The Patient Health Questionnaire-9(PHQ-9)was employed to investigate the depression state of the pregnant women,and the GDM group was subgrouped into normal group,mild group,moderate group and moderate-severe group according to the PHQ-9 score.Enzyme-linked immunosorbent assay was used to detect the levels of serum astrocyte-derived protein S100B,glial cell line-derived neurotrophic factor(GDNF),brain-derived neurotrophic factor(BDNF),interleukin(IL)-1,IL-6 and tumor necrosis factorα(TNF-α)of the pregnant women at gestational week 30.The PHQ-9 depression scale score,incidence of prenatal depression,serum neurotrophic factors and inflammatory factors levels were compared between the GDM group and the control group,and serum levels of neurotrophic factors and inflammatory factors of pregnant women with GDM were compared among the four subgroups with different depression degrees.Besides,Spearman rank correlation was used to analyze the correlation of depression degree with serum levels of neurotrophic factors and inflammatory factors.Results Compared with the control group,the GDM group possessed higher PHQ-9 depression scale score and incidence rate of prenatal depression,increased levels of serum S100B,IL-1,IL-6 and TNF-α,and decreased serum GDNF and BDNF levels(all P<0.05).Serum S100B,IL-1,IL-6and TNF-αlevels of pregnant women with GDM increased in the order of the normal group,the mild group,the moderate group and the moderate-severe group,exhibiting statistically significant differences among groups(all P<0.05);correlation analysis revealed that among pregnant women with GDM,serum S100B,IL-1,IL-6 and TNF-αlevels rose,and serum GDNF and BDNF levels declined with the increase of depression de

关 键 词：妊娠糖尿病 产前抑郁症 神经营养因子 炎性细胞因子 

分 类 号：R714.256[医药卫生—妇产科学]