肺癌早期患者术后心理应激现状及应激相关因子HSP70、IFN-γ关联性
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摘要
目的探讨肺癌早期患者术后心理应激现状及应激相关因子热应激蛋白(HSP)70和干扰素(IFN)-γ表达情况。方法选取肺癌早期患者为研究对象,采用横断面调查研究方法,对研究对象进行问卷调查;调查问卷包括一般资料调查问卷和健康症状自评量表(SCL-90),用以评价肺癌早期患者术后心理应激程度;采用酶联免疫吸附试验检测血清HSP70、IFN-γ表达水平。结果共调查158例肺癌早期患者,其中男111例(70.2%)、女47例(29.8%)。患者SCL-90各项因子均高于常模,以焦虑、恐怖、躯体化、抑郁、人际关系敏感因子得分平均分较高(P<0.05)。血清HSP70表达水平在中度不适的肺癌早期患者表达水平最高(P<0.05),血清IFN-γ表达水平随着应激程度加重而降低(P<0.05);HSP70与躯体化因子呈正相关,与恐惧因子呈负相关,IFN-γ与恐惧因子呈负相关。结论肺癌早期患者术后广泛存在不同程度的心理问题,术后及时进行心理干预意义重大;HSP70、IFN-γ水平作为反映心理应激的监测指标存在一定的临床价值。
引文
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2 Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016;66(2):115-32.
3 Morrison EJ,Novotny PJ,Sloan JA,et al.Emotional problems,quality of life,and symptom burden in patients with lung cancer[J].Clin Lung Cancer,2017;18(5):497-503.
4 Zimmermann C,Swami N,Krzyzanowska M,et al.Early palliative care for patients with advanced cancer:a cluster-randomised controlled trial[J].Lancet,2014;383(9930):1721-30.
5 邵淑红,周彤彤,陈旭芳,等.老年肺癌住院患者应对方式与健康相关生活质量[J].中国老年学杂志,2016;36(12):5966-8.
6 Bortolato B,Hyphantis TN,Valpione S,et al.Depression in cancer:the many biobehavioral pathways driving tumor progression[J].Cancer Treat Rev,2017;52:58-70.
7 Long X,Gong X.Study of immune function and psychological intervention on patients with malignant tumor after radiotherapy[J].Biol Med Res,2017;28(5):2375-8.
8 Chen HM,Tsai CM,Wu YC,et al.Randomised controlled trial on the effectiveness of home-based walking exercise on anxiety,depression and cancer-related symptoms in patients with lung cancer[J].Br J Cancer,2015;112(3):438-45.
9 Chow KM,Chan JCY,Choi KKC,et al.A review of psychoeducational interventions to improve sexual functioning,quality of life,and psychological outcomes in gynecological cancer patients[J].Cancer Nurs,2016;39(1):20-31.
10 Hartl FU,Hayer-Hartl M.Converging concepts of protein folding in vitro and in vivo[J].Nat Struct Mol Biol,2009;16(6):574-81.
11 Kim JJ,Mandelli L,Lim S,et al.Association analysis of heat shock protein 70 gene polymorphisms in schizophrenia[J].Eur Arch Psychiatry Clin Neurosci,2008;258(4):239-44.
12 Gülnahar Y,K?sger HH,Tutar Y.A comparison of piezosurgery and conventional surgery by heat shock protein 70 expression[J].Int J Oral Maxillofac Surg,2013;42(4):508-10.
13 Roesslein M,Froehlich C,Miltenberger V,et al.Thiopental protects human neuroblastoma cells from apoptotic cell death--Potential role of heat shock protein 70[J].Life Sci,2015;139:40-5.
14 Yurinskaya MM,Mitkevich VA,Kozin SA,et al.HSP70 protects human neuroblastoma cells from apoptosis and oxidative stress induced by amyloid peptide isoAsp7-Aβ(1-42)[J].Cell Death Dis,2015;6(11):e1977.
15 Gao J,Shi LZ,Zhao H,et al.Loss of IFN-γ pathway genes in tumor cells as a mechanism of resistance to anti-CTLA-4 therapy[J].Cell,2016;167(2):397-404.
16 Schreiber RD,Old LJ,Smyth MJ.Cancer immunoediting:integrating immunity's roles in cancer suppression and promotion[J].Science,2011;331(6024):1565-70.