目的:探讨血浆神经递质与产后抑郁症(postpartum depression,PPD)的关联.方法:于2007年2至9月在湖南长沙3家三甲医院开展一项前瞻性巢式病例对照研究.运用爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale,EPDS)中文版对产后2周产妇进行PPD筛查,得分≥13分者确定为PPD患者(n=42).每个PPD患者按1∶1抽取正常产妇为对照组(n=42),两组按照分娩医院(同一医院)与年龄(±5岁)进行匹配.在产后2周抽取血液样本,比较PPD组和对照组产妇的血浆单胺类递质及肽类神经递质水平,其中血浆单胺类递质包括5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(dopamine,DA)、去甲肾上腺素(norepinephrine,NE),肽类神经递质包括神经肽Y(neuropeptide Y,NPY)和P物质(substance P,Sp).结果:PPD组5-HT和NPY血浆水平明显低于对照组,而NE和SP血浆水平明显高于对照组(均P＜0.05).PPD组NPY和NE血浆水平之间呈负相关(r=-0.36,P＜0.05).结论:PPD产妇存在多种神经递质水平的改变,不同神经递质之间具有潜在相互作用.%Objective:To determine associations between postpartum depression (PPD) and plasma neurotransmitters.Methods:We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha,Hunan,China from February to September 2007.The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD,with a score of 13 or higher as the cut-off for PPD.The women with matched age but without PPD and delivery within 5 years were selected as controls.The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine,5-HT),dopamine (DA),and norepinephrine (NE),and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42).Results:Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls.For women with PPD,a negative correlation between NPY and NE (r=-0.36,P＜0.05) was observed.Conclusion:There are changes in plasma levels of neurotransmitters in women with PPD,and there are potential interactions between different neurotransmitters.
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