血清GDNF、S100B、维生素D水平对产后抑郁症的预测价值分析  

Predictive value of joint detection of serum GDNF,S100B and vitamin D levels for postpartum depression in women with cesarean section

作　　者：张志龙 楚帅斐 杨佳佳 王敏 ZHANG Zhilong;CHU Shuaifei;YANG Jiajia;WANG Min(Department of Obstetrics and Gynecology,The Central Hospital of Luohe City,Henan 462000,China)

机构地区：[1]河南省漯河市中心医院妇产科,462000 [2]河南省人民医院妇产科,450000

出　　处：《淮海医药》2024年第3期231-235,共5页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关联合共建项目(LHGJ20221039)。

摘　　要：目的:探讨血清胶质细胞源性神经营养因子(GDNF)、S100钙结合蛋白B(S100B)、维生素D水平联合检测对剖宫产产妇发生产后抑郁的预测价值。方法:选取2021年9月—2023年9月某院产科孕39周以上待产孕妇104例为研究对象,均行剖宫产,根据爱丁堡抑郁量表(EPDS)评估产后抑郁情况,将发生产后抑郁产妇纳入观察组(18例),未发生产后抑郁产妇纳入对照组(86例)。比较2组产前、产后3 d EPDS评分及血清GDNF、S100B、维生素D水平,分析血清各指标水平与EPDS评分之间的相关性,分析血清各指标联合检测对产后抑郁的预测价值。结果:产后3 d,观察组EPDS评分[(18.93±2.24)分]高于对照组[(7.04±0.96)分](P<0.05);产后3 d,观察组血清GDNF、维生素D水平[(5.63±1.28)pg/mL、(22.85±3.26)ng/mL]低于对照组[(12.55±3.07)pg/mL、(32.19±4.02)ng/mL],血清S100B水平[(63.29±5.18)μg/mL]高于对照组[(42.67±3.49)μg/mL],差异均有统计学意义(P<0.05)。产后3 d,血清GDNF、维生素D水平与EPDS评分呈负相关(r=-0.624、-0.549,P均<0.05),S100B水平与EPDS评分呈正相关(r=0.573,P<0.05),且各指标联合预测产后抑郁的AUC为0.938(95%CI:0.873~0.976),最佳诊断敏感度为88.89%,特异度为87.21%,约登指数为0.761。结论:剖宫产产后抑郁患者血清中GDNF、维生素D表达下调,S100B表达上调,各指标水平与EPDS评分均具有一定相关性,联合检测可作为临床评估产后抑郁情况的辅助指标。Objective:To investigate the predictive value of joint detection of serum glial cell derived neurotrophic factor(GDNF),S100 calc-binding protein B(S100B)and vitamin D levels for postpartum depression in women with cesarean section.Methods:104 pregnant women over 39 weeks of pregnancy in a hospital from September 2021 to September 2023 were selected as research subjects,all of whom were scheduled to undergo cesarean section.The postpartum depression status was evaluated using the Edinburgh Postnatal Depression Scale(EPDS).The women who developed postpartum depression were included in an observation group(18 cases),while those who did not were included in a control group(86 cases).EPDS scores and serum levels of GDNF,S100B and vitamin D 3 days before and 3 days after delivery were compared between the two groups,the correlation between serum levels and EPDS scores was observed,and the predictive value of combined detection of the serum indicators for postpartum depression was analyzed.Results:The postpartum 3-day EPDS score in the observation group was(18.93±2.24)higher than the control group's(7.04±0.96)(P<0.05).The postpartum 3-day serum GDNF and vitamin D levels in the observation group were(5.63±1.28)pg/ml and(22.85±3.26)ng/ml,respectively,both lower than those in the control group[(12.55±3.07)pg/mL,(32.19±4.02)ng/mL],and the serum S100B level was(63.29±5.18)μg/mL,which was higher than that in the control group(42.67±3.49)μg/mL(P<0.05).The postpartum 3-day serum GDNF and vitamin D levels were negatively correlated with the EPDS score(r=-0.624 and-0.549,all P<0.05),and the S100B level was positively correlated with the EPDS score(r=0.573,P<0.05).The AUC of each indicator for predicting postpartum depression was 0.938(95%CI:0.873~0.976),with an optimal diagnostic sensitivity of 88.89%and a specificity of 87.21%,and the Youden index was 0.761.Conclusion:The expression of GDNF and vitamin D in serum of patients with postpartum depression after cesarean section is down-regulated,and S100B expression is up-

关 键 词：抑郁症 产后 胶质细胞源性神经营养因子 S100钙结合蛋白B 维生素D 

分 类 号：R714.46[医药卫生—妇产科学]