摘要
目的:探讨高龄初产妇血清胶质细胞源性神经营养因子(GDNF)、血管紧张素转化酶(ACE)表达及与产前抑郁的可能关系。方法:选取2019年1月1日—2020年12月31日在台州医院产前检查的年龄≥35岁初产妇300例作为高龄组,同期产前检查正常的<35岁初产妇300例作为对照组。根据产前有无抑郁将高龄组分为非抑郁(178例)和抑郁(122例)。使用汉密尔顿抑郁量表-17(HAMD-17)评估高龄组产前抑郁程度,其中轻度抑郁41例、中度抑郁49例、重度抑郁32例。酶联免疫吸附法检测血清GDNF,连续监测法检测血清ACE。采用Pearson检验分析产前抑郁产妇血清GDNF、ACE与HAMD-17评分相关性,绘制受试者工作特征曲线(ROC),分析血清GDNF、ACE对高龄初产妇产前发生抑郁的预测价值。结果:血清GDNF水平,高龄组低于对照组,抑郁产妇低于非抑郁产妇,且在重度抑郁产妇最低、中度抑郁产妇其次、轻度抑郁产妇最高;血清ACE水平,高龄组高于对照组,抑郁产妇高于非抑郁产妇,且在重度抑郁产妇最高、中度抑郁产妇其次、轻度抑郁产妇最低(均P<0.05)。产前抑郁的高龄初产妇血清GDNF水平与HAMD-17评分呈负相关(P<0.05),血清ACE水平与HAMD-17评分呈正相关(P<0.05)。ROC曲线分析显示,血清GDNF联合ACE预测高龄初产妇产前发生抑郁的曲线下面积为0.930,高于血清GDNF或ACE单独检测(P<0.05),且预测敏感度(94.0%)、特异度(88.0%)最高。结论:产前抑郁产妇血清GDNF水平降低、ACE水平升高,二者联合检测可能是早期预测高龄初产妇产前抑郁的敏感指标。
Objective: To investigate the expression of serum glial cell-derived neurotrophic factor(GDNF) and angiotensin converting enzyme(ACE) of primipara with advanced age, and to analyze the relationship between GDNF and ACE levels and their antenatal depression occurrence. Methods: 300 primipara with advanced age were selected in the study group from January 1, 2019 to December 31, 2020, and another 300 young normal primiparas were selected in control group during the same period. According to their prenatal depression status, the primiparas in the study group were divided into group A(178 primiparas without depression) and group B(122 primiparas with depression). Hamilton depression scale-17(HAMD-17) was used to evaluate the degree of antenatal depression of the primiparas in the study group, which included 41 primiparas with mild depression group, 49 primiparas with moderate depression, and 32 primiparas with severe depression. Enzyme linked immunosorbent assay(ELISA) was used to detect the expression level of GDNF, and continuous monitoring method was used to detect the expression level of ACE. Pearson test was used to analyze the correlation between the expression levels of GDNF and ACE of the primiparas and their HAMD-17 score. The receiver operating characteristic curve(ROC curve) was drawn to analyze the value of serum GDNF and ACE expression levels for predicting the occurrence of depression of the primipara in the study group. Results: The serum GDNF level of the primipara in the study group was significant lower than that of the primipara in the control group,and that of the primipara in group B was significant lower than that of the primipara in group A,and that of primiparas with severe depression was the lowest,and that of primiparas with mild depression was the highest.The serum ACE level of the primipara in the study group was significant higher than that of the primipara in the control group,and that of the primipara in group B was significant higher than that of the primipara in group A,and that of primiparas with severe depression was the highest,and that of primiparas with mild depression was the lowest(all P<0.05).The serum GDNF expression level of the primiparas with depression in the study group was negative correlation with their HAMD-17 score(P<0.05),but the serum ACE expression level was positive correlation with their HAMD-17 score(P<0.05).ROC curve showed that the area under the curve of serum GDNF level combined with ACE level for predicting antenatal depression of the primiparas in the study group was 0.930,which was significant higher than that of serum GDNF level or ACE level alone(P<0.05).The sensitivity and the specificity of serum GDNF level combined with ACE level for predicting antenatal depression of the primiparas in the study group was 94.0%and 88.0%,which were the highest.Conclusion:The serum GDNF level of pregnant women with antenatal depression decreases,and their serum ACE level increases.The combination of the levels of GDNF and ACE maybe the sensitive index for predicting antenatal depression early of the primiparas with advanced age.
作者
杨龙腾
颜慧
叶丽娅
庞敏丽
YANG Longteng;YAN Hui;YE Liya;PANG Minli(The Second People's Hospital of Taizhou,Zhejiang Province,317200;Taizhou Hospital,Zhejiang Province)
出处
《中国计划生育学杂志》
2021年第3期611-615,共5页
Chinese Journal of Family Planning
基金
浙江省台州市科技计划项目(XM20190472)。
关键词
高龄初产妇
产前抑郁
胶质细胞源性神经营养因子
血管紧张素转化酶
预测
Primiparas with advanced age
Antenatal depression
Glial cell-derived neurotrophic factor
Angiotensin converting enzyme
Prediction
