Omura Izumi, Mizutani Masako, Goto Setsuko, Hashimoto Ryo, Kitagami Tomitsune, Miura Hideki, Ohta Tatsuro
Nagoya City University School of Nursing, Nagoya, Japan.
Neuropsychobiology. 2002;45(3):134-8. doi: 10.1159/000054953.
Plasma total biopterin and tetrahydrobiopterin levels of 14 normal pregnant and 15 normal puerperal women (within 1 week after delivery) were measured. In the first group, total biopterin levels were already increased (average: 18.2 pmol/ml) in the second trimester and remained high until the early puerperal period. In the second trimester, the ratio of tetrahydrobiopterin to total biopterin levels decreased to 72.3% and even further to 66.1% in the third trimester. This tendency continued until the puerperal period. Compared with the control group (12 healthy nonpregnant women), total biopterin levels increased during pregnancy and the puerperal period (p < 0.001), and the ratio in the third trimester and the early puerperal period decreased (p < 0.001). The depressive state according to Zung's score appeared most markedly in the third trimester with a mean score of 48, and tended to recover to a mean score of 36.2 in the early puerperal period. In this period, a correlation was found between Zung's score and the total biopterin levels (r = 0.80), and the ratio of tetrahydrobiopterin levels to the total biopterin levels (r = -0.92). In the early puerperal period, total biopterin levels were higher in subjects with Zung's scores > or = 36 (p < 0.001); the ratios of this group were lower than those of subjects with Zung's scores <36 (p < 0.001). Plasma biopterin levels in pregnancy and the early puerperal period closely resembled those of patients with mood disorders who show depressive symptoms from a psychoneurological perspective. Therefore, it seems possible that a depressive state in pregnancy and the early puerperal period has the same pathology as depression.
对14名正常孕妇和15名正常产后妇女（产后1周内）的血浆总生物蝶呤和四氢生物蝶呤水平进行了测定。在第一组中，总生物蝶呤水平在孕中期就已升高（平均：18.2 pmol/ml），并一直保持较高水平直至产褥早期。在孕中期，四氢生物蝶呤与总生物蝶呤水平的比值降至72.3%，在孕晚期甚至进一步降至66.1%。这种趋势一直持续到产褥期。与对照组（12名健康未孕妇女）相比，孕期和产褥期总生物蝶呤水平升高（p<0.001），孕晚期和产褥早期的比值降低（p<0.001）。根据zung评分，抑郁状态在孕晚期最为明显，平均评分为48分，在产褥早期倾向于恢复到平均36.2分。在此期间，发现zung评分与总生物蝶呤水平之间存在相关性（r = 0.80），以及四氢生物蝶呤水平与总生物蝶呤水平的比值之间存在相关性（r = -0.92）。在产褥早期，zung评分≥36的受试者总生物蝶呤水平较高（p<0.001）；该组的比值低于zung评分<36的受试者（p<0.001）。孕期和产褥早期的血浆生物蝶呤水平与从精神神经学角度表现出抑郁症状的情绪障碍患者的水平非常相似。因此，孕期和产褥早期的抑郁状态似乎与抑郁症具有相同的病理机制。
