首发围绝经期抑郁症病人血清雌激素水平动态变化及其与认知功能的相关性  

Dynamic changes in serum oestrogen levels and their association with cognitive function in patients with first perimenopausal depression

作　　者：苏晓云[1] 贺继平[1] 张晓宇 张丽娜 杨芯雨 SU Xiaoyun;HE Jiping;ZHANG Xiaoyu;ZHANG Li′na;YANG Xinyu(Fenyang College of Shanxi Medical University,Shanxi 032200 China)

机构地区：[1]山西医科大学汾阳学院,山西032200 [2]山西省汾阳医院

出　　处：《护理研究》2024年第13期2302-2310,共9页Chinese Nursing Research

基　　金：2022年度吕梁市科学计划项目,编号:2022SHFZ25。

摘　　要：目的:探究首发围绝经期抑郁症病人血清雌激素水平动态变化及其与认知功能的相关性。方法:选取2021年12月-2022年12月于山西省汾阳医院就诊的首发围绝经期抑郁症病人127例纳入围绝经期抑郁症组,选取同期于我院进行体检的200名围绝经期妇女纳入对照组。收集两组女性的一般资料,并于就诊时和就诊后3个月、6个月及12个月检测两组性激素[雌酮(E1)、雌二醇(E2)、血清催乳素(PRL)、卵泡刺激素(FSH)和黄体生成素(LH)]、神经递质因子[去甲肾上腺素(NE)、多巴胺(DA)、脑源性神经营养因子(BDNF)和5⁃羟色胺(5⁃HT)]水平;并使用蒙特利尔认知评估量表(MoCA)评估病人的认知功能,根据病人就诊后12个月认知功能评分将病人分为认知障碍组(n=94)和认知正常组(n=33),比较两组病人临床资料与血清学指标,并使用多因素Logistic回归模型分析认知功能的影响因素。结果:围绝经期抑郁症组妇女E1、E2、NE、DA、BDNF、5⁃HT水平低于对照组(P<0.05),PRL、FSH、LH水平高于对照组(P<0.05)。随时间进展,围绝经期抑郁症病人E1、E2、NE、DA、BDNF、5⁃HT水平呈现逐渐降低趋势,且各时间点间比较差异有统计学意义(P<0.05);随时间进展,围绝经期抑郁症组病人PRL、FSH、LH水平呈现逐渐上升趋势,且各时间点间比较差异有统计学意义(P<0.05)。逐步排除混杂因素后,激素指标与围绝经期抑郁症病人认知障碍风险仍有相关性(P<0.001)。结论:不同性激素及神经递质因子水平会影响围绝经期抑郁症的发生,且围绝经期妇女认知功能与性激素、神经递质因子水平有一定的相关性,建议对围绝经期妇女进行性激素动态水平监测,以对围绝经期抑郁症进行早期干预。Objective:To investigate the dynamic changes of serum oestrogen levels in patients with first⁃episode perimenopausal depression(PMD)and their correlation with cognitive function.Methods:127 patients with first⁃episode PMD who visited Shanxi Fenyang Hospital from December 2021 to December 2022 were selected to be included in the PMD group,and 200 perimenopausal women who underwent a physical examination at our hospital during the same period were selected to be included in the control group.General information was collected and levels of sex hormones(oestrone(E1),oestradiol(E2),serum prolactin(PRL)),follicle⁃stimulating hormone(FSH),and luteinising hormone(LH),and norepinephrine(NE),dopamine(DA),brain⁃derived neurotrophic factor(BDNF),and 5⁃hydroxytryptophan(5⁃HT)were measured in both groups at the time of visit;sex hormone and neurotransmitter levels were measured at different time points(at the time of consultation,3 months,6 months and 12 months after consultation)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA)in the PMD group;sex hormone and neurotransmitter levels were analysed in relation to cognitive function using pearson′s correlation;and risk factors affecting PMD were analysed using either unifactorial or multifactorial logistic regression equations;patients were divided into a cognitively impaired group(n=94)and a cognitively normal group(n=33)based on their MoCA scores at 12 months after the consultation,and clinical data and serological indices were compared between the two groups;the risk factors analysed using multifactorial logistic regression modelling.Results:The levels of E1,E2,NE,DA,BDNF,and 5⁃HT in the PMD group were significantly lower than those in the control group(P<0.05);and the levels of PRL,FSH,and LH in the women in the PMD group were significantly higher than those in the control group(P<0.05).With the increase of time,the levels of E1,E2,NE,DA,BDNF,and 5⁃HT in PMD patients showed a trend of gradual decrease,and there was a si

关 键 词：围绝经期抑郁症 雌激素 认知功能 影响因素 调查研究 

分 类 号：R473.74[医药卫生—护理学]