中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
28期
251-253
,共3页
李榕卿%林实%赵士芳%徐斌
李榕卿%林實%趙士芳%徐斌
리용경%림실%조사방%서빈
应激%免疫蛋白脂类%唾液分泌
應激%免疫蛋白脂類%唾液分泌
응격%면역단백지류%타액분비
背景:近年来临床和流行病学相关研究都证实部分口腔疾病的发生与心理应激因素相关.目的:分析学生考试前后唾液分泌型IgA及皮质醇的变化与心理应激状况的关系.设计:横断面调查. 单位:浙江大学口腔系.对象:调查对象为2003-05/11福州二中高二年级在校学生60人,57人完成调查,均为男性,年龄17～19岁,身体健康,无口腔疾病及免疫系统疾病家庭史,无烟酒嗜好,均参加为期3d的期末考试.方法:考试前应用症状自评量表(共90题,包括躯体化、强迫、人际关系敏感、忧郁、焦虑、敌对、恐惧、偏执、精神病性、其他等10个因素,总均分是将总分除以90),将完成调查的57人分为为低症状组(症状自评量表总分＜2.0)和高症状组(症状自评量表总分＞2.0).于考试前5周召集学生填写一般情况调查表;考试前4周和考试当天早晨7:30完成第一、二次唾液标本采集,测定其考试应激前后唾液分泌型IgA、皮质醇值;考试后3 d召集学生填写心理健康问卷,评定其心理健康状况.主要观察指标:①症状自评表得分.②应激前后唾液分泌型IgA及皮质醇水平.结果:采用意向处理分析,进入结果分析57人.①学生症状自评表评定结果与中国常模比较:考试后强迫、焦虑、敌对、偏执4个因子分高于中国常模[(1.98±0.72,1.69±0.61)分;(1.79±0.31,1.42±0.43)分;(1.77±0.68,1.50±0.57)分;(2.00±0.71,1.52±0.60)分,(P＜0.01)],其他因子比较未见明显差异(P＞0.05).②应激后的唾液分泌型IgA分泌量比较:考试前低症状组明显高于高症状组[(236.6±82.29,194.55±66.29)mg/L,(P＜0.05)];考试后低症状组学生唾液分泌型IgA分泌量高于高症状组[(182.21±55.92,132.89±41.16)mg/L,(P＜0.01)];③应激后的唾液皮质醇浓度比较:低症状组考试后明显高于考试前[(5.96±2.46,3.68±2.26)μg/L,(P＜0.01)].④两组分泌型IgA变化率及皮质醇变化率逐步回归分析结果:分泌型IgA下降率(0.012±0.197)、皮质醇上升率(0.199±0.654)和偏执、强迫等心理因素有关.结论:学生考试后症状自评表评定结果中焦虑、强迫、敌对、偏执等因子分高于中国常模,显示考试应激造成学生焦虑水平的上升和心理行为方面变异.高、低症状组学生在考试应激前后唾液分泌型IgA下降率之间存在差异,表明心理症状较多的学生对考试应激耐受力低.
揹景:近年來臨床和流行病學相關研究都證實部分口腔疾病的髮生與心理應激因素相關.目的:分析學生攷試前後唾液分泌型IgA及皮質醇的變化與心理應激狀況的關繫.設計:橫斷麵調查. 單位:浙江大學口腔繫.對象:調查對象為2003-05/11福州二中高二年級在校學生60人,57人完成調查,均為男性,年齡17～19歲,身體健康,無口腔疾病及免疫繫統疾病傢庭史,無煙酒嗜好,均參加為期3d的期末攷試.方法:攷試前應用癥狀自評量錶(共90題,包括軀體化、彊迫、人際關繫敏感、憂鬱、焦慮、敵對、恐懼、偏執、精神病性、其他等10箇因素,總均分是將總分除以90),將完成調查的57人分為為低癥狀組(癥狀自評量錶總分＜2.0)和高癥狀組(癥狀自評量錶總分＞2.0).于攷試前5週召集學生填寫一般情況調查錶;攷試前4週和攷試噹天早晨7:30完成第一、二次唾液標本採集,測定其攷試應激前後唾液分泌型IgA、皮質醇值;攷試後3 d召集學生填寫心理健康問捲,評定其心理健康狀況.主要觀察指標:①癥狀自評錶得分.②應激前後唾液分泌型IgA及皮質醇水平.結果:採用意嚮處理分析,進入結果分析57人.①學生癥狀自評錶評定結果與中國常模比較:攷試後彊迫、焦慮、敵對、偏執4箇因子分高于中國常模[(1.98±0.72,1.69±0.61)分;(1.79±0.31,1.42±0.43)分;(1.77±0.68,1.50±0.57)分;(2.00±0.71,1.52±0.60)分,(P＜0.01)],其他因子比較未見明顯差異(P＞0.05).②應激後的唾液分泌型IgA分泌量比較:攷試前低癥狀組明顯高于高癥狀組[(236.6±82.29,194.55±66.29)mg/L,(P＜0.05)];攷試後低癥狀組學生唾液分泌型IgA分泌量高于高癥狀組[(182.21±55.92,132.89±41.16)mg/L,(P＜0.01)];③應激後的唾液皮質醇濃度比較:低癥狀組攷試後明顯高于攷試前[(5.96±2.46,3.68±2.26)μg/L,(P＜0.01)].④兩組分泌型IgA變化率及皮質醇變化率逐步迴歸分析結果:分泌型IgA下降率(0.012±0.197)、皮質醇上升率(0.199±0.654)和偏執、彊迫等心理因素有關.結論:學生攷試後癥狀自評錶評定結果中焦慮、彊迫、敵對、偏執等因子分高于中國常模,顯示攷試應激造成學生焦慮水平的上升和心理行為方麵變異.高、低癥狀組學生在攷試應激前後唾液分泌型IgA下降率之間存在差異,錶明心理癥狀較多的學生對攷試應激耐受力低.
배경:근년래림상화류행병학상관연구도증실부분구강질병적발생여심리응격인소상관.목적:분석학생고시전후타액분비형IgA급피질순적변화여심리응격상황적관계.설계:횡단면조사. 단위:절강대학구강계.대상:조사대상위2003-05/11복주이중고이년급재교학생60인,57인완성조사,균위남성,년령17～19세,신체건강,무구강질병급면역계통질병가정사,무연주기호,균삼가위기3d적기말고시.방법:고시전응용증상자평량표(공90제,포괄구체화、강박、인제관계민감、우욱、초필、활대、공구、편집、정신병성、기타등10개인소,총균분시장총분제이90),장완성조사적57인분위위저증상조(증상자평량표총분＜2.0)화고증상조(증상자평량표총분＞2.0).우고시전5주소집학생전사일반정황조사표;고시전4주화고시당천조신7:30완성제일、이차타액표본채집,측정기고시응격전후타액분비형IgA、피질순치;고시후3 d소집학생전사심리건강문권,평정기심리건강상황.주요관찰지표:①증상자평표득분.②응격전후타액분비형IgA급피질순수평.결과:채용의향처리분석,진입결과분석57인.①학생증상자평표평정결과여중국상모비교:고시후강박、초필、활대、편집4개인자분고우중국상모[(1.98±0.72,1.69±0.61)분;(1.79±0.31,1.42±0.43)분;(1.77±0.68,1.50±0.57)분;(2.00±0.71,1.52±0.60)분,(P＜0.01)],기타인자비교미견명현차이(P＞0.05).②응격후적타액분비형IgA분비량비교:고시전저증상조명현고우고증상조[(236.6±82.29,194.55±66.29)mg/L,(P＜0.05)];고시후저증상조학생타액분비형IgA분비량고우고증상조[(182.21±55.92,132.89±41.16)mg/L,(P＜0.01)];③응격후적타액피질순농도비교:저증상조고시후명현고우고시전[(5.96±2.46,3.68±2.26)μg/L,(P＜0.01)].④량조분비형IgA변화솔급피질순변화솔축보회귀분석결과:분비형IgA하강솔(0.012±0.197)、피질순상승솔(0.199±0.654)화편집、강박등심리인소유관.결론:학생고시후증상자평표평정결과중초필、강박、활대、편집등인자분고우중국상모,현시고시응격조성학생초필수평적상승화심리행위방면변이.고、저증상조학생재고시응격전후타액분비형IgA하강솔지간존재차이,표명심리증상교다적학생대고시응격내수력저.
BACKGROUND: It has been verified in relevant clinical and epidemiological researches in recent years that a part of stomatopathy is associated to psychological stress factors.OBJECTIVE: To analyze the relationship between the changes in salivary secretory IgA and cortisol and psychological stress states.DESIGN: cross-sectional investigation was designed.SETTING: Department of Stomatology, Zhejiang University.PARTICIPANTS: The investigated participants were 60 students in the 2nd grade of Fuzhou №.2 Senior School selected from May to November 2003. Fifty-seven of them accomplished the investigation, of male; aged varied from 17 to 19 years, of healthy, no stomatopathy and family history of disorders in immune system and without indulgence in smoke and alcohol. All of them had participated in the 3-day terminal exam.METHODS: Before the exam, evaluation with symptom checklist (there are 90 questions, including about 10 factors, such as somatization, compulsive state, sensitive interpersonal relationships, melancholy, anxiety, hostility, fear, paranoid state, psychotic state and others. The total average score results by divided total score with 90. ) was applied. Fifty-seven students that had accomplished the investigation were divided in low-symptom group (the total score of symptom checklist ＜ 2.0) and high-symptom group (the total score ≥ 2.0). 5 weeks before the exam, the students were called together to fill up investigation form of general situation. Four weeks before the exam and at 7: 30 am on the day of exam, the first and second saliva specimens were collected respectively to determine salivary secretory IgA and cortisol before and after exam stress. The students were called together again 3 days after exam to fill up questionnaire on psychological health to evaluate their psychological health state.stress.RESULTS: Intention management analysis was adopted, in which 57 stulist with Chinese norm: after exam, the scores of 4 factors, named compulsive state, anxiety, hostility and paranoid state, were higher than Chinese norm [(1.98±0.72, 1.69±0.61) scores; (1.79±0.31, 1.42±0.43) scores; (1.77±0.68,1.50±0.57)scores; (2.00±0.71, 1.52±0.60)scores, P ＜ 0.01] and there was parison of salivary secretory IgA content after stress: that before exam in low symptom group was remarkably higher than that in high symptom group [(236.6±82.29),(194.55±66.29) mg/L, P ＜ 0.05], that after exam in low symptom group was higher than that in high symptom group [(182.21±55.92,tration after stress: that after exam in low symptom group was remarkably higher than that in high symptom group [(5.96±2.46, 3.68±2.26) μg/L, P secretory IgA and cortisol in two groups: the decrease rate of secretory IgA (0.012±0.197) and increase rate of cortisol (0.199±0.654) were relevant to compulsive state and paranoid state.CONCLUSION: In evaluation with symptom checklist after exam, the scores of anxiety, compulsive state, hostility and paranoid state were higher than Chinese norm, indicating that exam stress induces increased anxiety level and variation of psychological behavior of students. The difference presented in decrease rate of salivary secretory IgA before and after exam stress between high and low symptom groups, explaining that the students with more psychological symptoms are weak to endure exam stress.
