摘要
目的研究不孕不育患者抑郁情绪与甲状腺激素、同型半胱氨酸水平的性别异质性、，方法选取2015年12月至2017年4月在华北理工大学附属唐山市妇幼保健院治疗的不孕不育患者250例为研究对象，采用抑郁自评量表（Self-Rating Depression Scale，SDS）评估患者的抑郁状况，以伴抑郁情绪的不孕不育患者为不孕不育伴抑郁组，以没有抑郁情绪的不孕不育患者为不孕不育非抑郁组，并按性别将不孕不育伴抑郁组分为男性不育伴抑郁组与女性不孕伴抑郁组，分别测定其甲状腺激素、同型半胱氮酸水平。结果①不孕不育伴抑郁情绪患者的超敏促甲状腺素（ThyroidStimula—tingHormone，TSH）和同型半胱氨酸（Homocysteine，Hcy）水平较无抑郁情绪者高，差异有统计学意义[（2．045＋1．253）uIU／ml，（2．412±1．236）uIU／ml，t=-2．287，P=0．023；（15．411±9．143）rnmol／L，（19．129±13．087）mmol／L，t=-2．467，P=0．014]。②不孕不育患者抑郁程度的性别差异无统计学意义（x2=0．483，P=0．785）。③男性不育伴抑郁患者三碘甲腺原氨酸（Triiodothyronine，T3）、甲状腺素（Thyrox—ine，T4）、Hey均显著高于女性不孕伴抑郁者[（1．926±0．648）nmol／L，（1．712±0．416）nmol／L，t=2．457，P=0．015；（117．86±19．311）nmol／L，（110．185±18．999）nmol／L，t=2．434，P=0．016；（15．575±4．139）mmol／L，（12．277＋3．921）mmol／L，t=4．982，P〈0．01]，而TSH较女性组低，差异有统计学意义[（2．496±1．329）uIU／ml，（3．057±1．583）ulU／ml，t=-2．303，P=0．023]。④女性不孕与男性不育患者TSH、Hcy与SDS指数存在显著正相关，TSH、Hcy对SDS评分具有显著正向预测力。结论不孕小育伴抑郁患者甲状腺激素、同型半胱氨酸水平存在性别差异，并与抑郁情绪相关，应重视不孕不育患者的抑郁情绪及其体内生物水平变化，关注其可能存在的性别异质性问题。
Objective To explore the gender heterogeneity of depression and thyroid hormone and homocysteine levels in infertile patients.Methods Totally 250 patients with infertility were selected in Tang- sham Maternal and Child Health Care Hospital affiliated to North China University of Science and Technology from December 2015 to April 2017.The Serf-Rating Depression Scale（SDS） was used to evaluated the pa- tients＇ s depression.The patients with infertility and depression were divided into infertility and depression group, and the patients with infertility but without depression were infertile and non-depressed group, patients with infertility and depression were divided into male infertility and depression group and female infertility group with depression, and the levels of thyroid hormone and homocysteine were measured respectively. Re- suits （1）The thyroid stimulating hormone and homocysteine levels in infertility patients with depression were significantly higher than those without depression （ （ 2.045± 1.253 ） uIU/ml, （ 2.412±1.236） uIU/ml, t= -2.287, P= 0.023 ; （ 15.411 ±9.143 ） mmol/L, （ 19.129±13.087 ） mmol/L, t= - 2.467, P= 0.014 ）. （2）There was no statistically significant difference in the degree of depression between male and female infertility patients （ X2 = 0.483 ,P= 0.785 ） .（3） The levels of tfiodothyronine, thyroxine and homocysteine in male infertility pa- tients with depression were significantly higher than those in female patients（ （1.926±0.648） nmol/L, （ 1.712±0.416） nmol/L,t= 2.457,P= 0.015 ; （ 117.86±19.311 ） nmol/L, （ 110.185± 18.999） nmol/L, t= 2.434,P= 0. 016; （15.575±4.139） mmoL/L, （ 12.277±3.921 ） mmol/L,t= 4.982,P〈0.01 ）, and the TSH was lower than that in the female group（ （ 2.496±1.329 ） ulU/ml, （ 3.057±1.583 ） ulU/ml, t= -2.303, P= 0.023 ） .@The TSH and Hcy levels of male and female infertility patients were significantly positively correlated with SDS inde- xes, and had a significant positive predictive power to SDS score.Conclusion The levels of thyroid hormone and homocysteine are different in gender in infertile patients with depression, and the thyroid hormone and homocysteine are related to the depression.so we should pay attention to the depression symptoms of infertility patients and the changes of their biological levels, especially the gender heterogeneity.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2017年第11期1036-1041,共6页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家卫生计生委计划生育与优生重点实验室开放课题（20150006）
河北省医学科学研究重点课题计划立项项目（20160218）
河北省中医约管理局中医药类科研计划项目（2016079）
作者简介
通信作者：王树松，Email：wshsong@sina．com
