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原发性内源性抑郁症的神经内分泌方面——第十四部分。女性患者及其配对对照者的促性腺激素分泌

Neuroendocrine aspects of primary endogenous depression--XIV. Gonadotropin secretion in female patients and their matched controls.

作者信息

O'Toole S M, Rubin R T

机构信息

Neurosciences Research Center, Allegheny-Singer Research Institute, Medical College of Pennsylvania, Pittsburgh 15212-4772, USA.

出版信息

Psychoneuroendocrinology. 1995;20(6):603-12. doi: 10.1016/0306-4530(95)00006-a.

DOI:10.1016/0306-4530(95)00006-a
PMID:8584601
Abstract

To determine the extent of dysregulation of gonadotropin secretion in depressed women, we measured nocturnal and diurnal serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations and the responses of these hormones to gonadotropin releasing hormone (LHRH) in 20 Research Diagnostic Criteria primary, definite endogenous female depressives and in 20 individually matched female normal controls. Fourteen patients and 14 controls were premenopausal, and six patients and six controls were peri/postmenopausal or panhysterectomized. None of the latter was receiving estrogen replacement therapy. The premenopausal patients showed no significant differences in basal nocturnal or diurnal gonadotropin concentrations and no significant differences in hormone concentrations post-LHRH compared to their premenopausal matched controls. In contrast, in the postmenopausal subjects there were (1) significantly increased diurnal vs. nocturnal serum FSH concentrations in the depressives; (2) marginally increased nocturnal, diurnal, and LHRH-stimulated LH concentrations and highly significantly increased LHRH-stimulated FSH concentrations in the depressives compared to their controls; and (3) positive correlations between the LH measures and ratings of depression severity in the patients. These results suggest a dysregulation of the HPG axis in peri/postmenopausal and panhysterectomized female endogenous depressives.

摘要

为了确定抑郁女性促性腺激素分泌失调的程度,我们测定了20名符合研究诊断标准的原发性、明确的内源性女性抑郁症患者以及20名个体匹配的女性正常对照者的夜间和日间血清促黄体生成素(LH)和促卵泡生成素(FSH)浓度,以及这些激素对促性腺激素释放激素(LHRH)的反应。14名患者和14名对照者处于绝经前,6名患者和6名对照者处于围绝经期/绝经后或接受了全子宫切除术。后者均未接受雌激素替代治疗。绝经前患者与绝经前匹配的对照者相比,夜间或日间基础促性腺激素浓度无显著差异,LHRH注射后激素浓度也无显著差异。相比之下,在绝经后受试者中,(1)抑郁症患者日间血清FSH浓度较夜间显著升高;(2)与对照组相比,抑郁症患者夜间、日间及LHRH刺激后的LH浓度略有升高,LHRH刺激后的FSH浓度显著升高;(3)患者的LH测量值与抑郁严重程度评分之间呈正相关。这些结果表明,围绝经期/绝经后及全子宫切除的女性内源性抑郁症患者存在下丘脑-垂体-性腺轴失调。

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