【摘要】： 目的:了解多囊卵巢綜合征(PCOS)合并不孕癥患者心理健康狀況、血清單胺類神經(jīng)遞質(zhì)濃度,并探討心理健康狀況與血清單胺類神經(jīng)遞質(zhì)的關(guān)系以及單胺類神經(jīng)遞質(zhì)與性激素的關(guān)系,為PCOS合并不孕癥患者的綜合治療提供資料。 方法:以不孕癥合并PCOS患者30例為實驗組,不孕癥未合并PCOS患者30例為對照組,使用精神癥狀自評量表(SCL-90)統(tǒng)計兩組在抑郁、焦慮、強(qiáng)迫等精神癥狀方面因子分平均水平,并且采用庫侖陣列電化學(xué)高效液相色譜檢測血清單胺類神經(jīng)遞質(zhì)濃度,包括去甲腎上腺素(NE)、多巴胺(DA)、5-羥色胺(5-HT)及其相應(yīng)代謝物3-甲氧基-4-羥基苯乙醇(MHPG)、高香草酸(HVA)和3,4-雙羥苯乙酸(DOPAC)、5-羥吲哚醋酸(5-HIAA),結(jié)合血清性激素水平,分析SCL-90因子分與血清單胺類神經(jīng)遞質(zhì)濃度的相關(guān)性,以及單胺類神經(jīng)遞質(zhì)與性激素的相關(guān)性。 結(jié)果:1、實驗組PCOS合并不孕癥患者SCL-90抑郁、焦慮因子分與對照組比較有統(tǒng)計學(xué)差異(P＜0.05),可認(rèn)為PCOS組SCL-90抑郁、焦慮因子分高于非PCOS組。 2、實驗組PCOS合并不孕癥患者血清5-HT、5-HIAA、HVA濃度與對照組比較有統(tǒng)計學(xué)差異(P＜0.05),可認(rèn)為PCOS組5-HT、5-HIAA、HVA濃度低于非PCOS組。 3、對SCL-90因子分與血清單胺類神經(jīng)遞質(zhì)濃度進(jìn)行相關(guān)分析,總樣本60例不孕癥恐怖因子分與MHPG呈正相關(guān)(r=.302;P=0.004),精神病性因子分與MHPG呈負(fù)相關(guān)(r=.093;P=0.070),人際關(guān)系敏感、敵對因子分與DOPAC分別呈負(fù)相關(guān)(r_(敏感)=-.246,P_(敏感)=0.012;r_(敵對)=-.218;P_(敵對)=0.031),精神病性因子分與DOPAC呈正相關(guān)(r=-.041;P=0.001)。PCOS組恐怖因子分與MHPG呈正相關(guān)(r=.334;P=0.071),敵對因子分與HVA、DOPAC分別呈負(fù)相關(guān)(r_(HVA)=-.313,P=0.092;r_(DOPAC)=-.416,P=0.022)。非PCOS組,未發(fā)現(xiàn)明顯相關(guān)性。 4、PCOS患者血清單胺類神經(jīng)遞質(zhì)與性激素濃度進(jìn)行相關(guān)分析,MHPG與卵泡刺激素(FSH)呈負(fù)相關(guān)(r=-609;p=0.000),DA與FSH呈正相關(guān)(r=.162;p=0.094),5-HT與總睪酮(TT)呈負(fù)相關(guān)(r=-.360;p=0.051)。 結(jié)論:1、PCOS合并不孕癥患者SCL-90抑郁、焦慮因子分較非PCOS組明顯升高。 2、PCOS合并不孕癥患者血清5-HT、5-HIAA、HVA濃度較非PCOS組明顯下降。 3、PCOS合并心理健康問題應(yīng)該得到臨床醫(yī)生的重視,可以嘗試通過心理對癥治療和給予神經(jīng)遞質(zhì)源類藥物的綜合治療改善目前不孕癥合并PCOS患者的治療現(xiàn)狀。
[Abstract]:Objective: to investigate the mental health and serum concentration of amine neurotransmitters in patients with polycystic ovary syndrome (PCOS) complicated with infertility. The relationship between mental health status and blood list amine neurotransmitters and between monoamine neurotransmitters and sex hormones was discussed in order to provide data for comprehensive treatment of PCOS patients with infertility. Methods: 30 cases of infertility complicated with PCOS and 30 cases of infertility without PCOS were used as experimental group and 30 cases as control group. Mental symptom Checklist (SCL-90) was used to calculate depression and anxiety in both groups. The average factor scores in mental symptoms such as compulsion were measured by Coulomb array electrochemical high performance liquid chromatography (ECLC) to detect the concentration of blood list amine neurotransmitters, including norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT) and its metabolites, 3-methoxy-4-hydroxyphenylethanol (MHPG), (HVA) and (DOPAC), 5-hydroxyindoleacetic acid (5-HIAA), combined with serum sex hormone levels. To analyze the correlation between SCL-90 factor score and serum concentration of amine neurotransmitters, and between monoamine neurotransmitters and sex hormones. Results: 1. The scores of SCL-90 depression and anxiety factor in PCOS patients with infertility in experimental group were significantly different from those in control group (P < 0. 05). It can be concluded that SCL-90 depression and anxiety factor score in PCOS group were higher than those in non PCOS group. 2. The serum 5-HT 5-HIAAA-HVA concentration of PCOS patients with infertility in the experimental group was significantly different from that of the control group (P < 0. 05). It can be concluded that the concentration of 5 HT 5 HIAA HVA in the PCOS group was lower than that in the non PCOS group. 3. The correlation between SCL-90 factor score and serum concentration of amine neurotransmitters was analyzed. There was a positive correlation between MHPG and phobic factor score in 60 cases of infertility (r.302), and a negative correlation between psychotic factor score and MHPG (r = 093). The scores of hostility factors were negatively correlated with DOPAC (r _ (sensitivity) =-.246) P _ (sensitivity) = 0.012 r _ (hostile) =-.218; P _ (hostile) = 0.031), psychotic factor scores were positively correlated with DOPAC (r-041) and MHPG (r-041); The scores of hostile factors were negatively correlated with HVA,DOPAC (r _ (HVA) =-.313P _ (0.092) P _ (DOPAC) =-.416p _ (0. 022). No significant correlation was found in non-PCOS group. 4 correlation analysis between serum monoamine neurotransmitters and sex hormone concentration in patients with PCOS showed that there was a negative correlation between serum monoamine neurotransmitters and follicle stimulating hormone (FSH) (r = 609), DA and FSH) (r = 162). There was a negative correlation between 5-HT and total testosterone (TT) (r = 0. 094), and a negative correlation between 5-HT and total testosterone (TT) (r ~ -. 360 ~ 0. 051). Conclusion: 1 the scores of SCL-90 depression and anxiety factor in PCOS patients with infertility were significantly higher than those in the non PCOS group. (2) the serum concentration of 5 HT 5 HIAA HVA in PCOS with infertility was significantly lower than that in non PCOS group. 3PCOS with mental health problems should be paid attention to by clinicians, we can try to improve the current treatment status of infertility patients with PCOS through psychotherapy and comprehensive treatment of neurotransmitter source drugs.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R395;R711.75;R711.6

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