创伤后应激障碍对机体免疫和心肌酶类的影响
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摘要
目的对汶川地震灾区执行救灾任务患有应激障碍的某师官兵的免疫和心肌酶类指标进行分析,并对其身心健康进行评估与干预。方法对上述人员T、B、NK淋巴细胞亚群等6项免疫指标和心肌酶类等4项指标进行测定,将其分为急性应激反应阳性组(A)和急性应激反应阴性组(B)组,并与正常健康组(C)比较。结果各组各项免疫指标均在正常范围。A组CD3+T淋巴细胞、CD3+CD4+T淋巴细胞高于B组(P<0.01,P<0.05);B组CD3+和CD3+CD4+T淋巴细胞计数低于C组(P<0.01),A、B组CD4/CD8均低于C组(P<0.01)。与B组比较,A组CD19+B淋巴细胞明显降低(P<0.05);与C组比较,B组CD19+B淋巴细胞和A组CD3-CD56+NK淋巴细胞显著增加(P<0.05)。提示应激组官兵免疫功能异常。另与C组比较,A组和B组AST、CK、CKMB、LDH均显著增加(P<0.01),尤其是CK,其结果已显示异常;提示对于参加一线救助的PTSD阳性和PTSD阴性部队官兵,与正常对照组比较,其心肌功能有遭受不同程度损伤趋势。结论应激障碍可致免疫功能异常及心肌酶类指标代谢紊乱。
Objective To analyze the immune function and myocardium enzyme in officers and soldiers of a division who developed stress disorder when they were helping the people to tide over the disaster in Wenchuan earthquake area,and to evaluate their mental and physical health.Methods The officers and soldiers were divided into positive post-traumatic stress disorder(PTSD) group(A),negative PTSD group(B),and normal control group(C).Their T,B,and NK lymphocyte subpopulations were detected and their myocardium enzyme levels including AST,CK,CKMB and LDH were measured,which were compared with those in the normal control group.Results The immune function was with normal range in 3 groups.The number of CD3+ and CD3+ CD4+ T lymphocytes was greater in group A than in group B,and was smaller in group B than in group C(P<0.01).The number of CD4/CD8 T lymphocytes was smaller in groups A and B than in group C(P<0.01).The number of CD19+ B lymphocytes was significantly smaller in group A than in group B(P<0.05).The number of CD19+ B lymphocytes in group B and the number of CD3-CD56+ NK lymphocytes in group A were significantly greater than in group C(P<0.01),indicating that the immune function of the officers and soldiers was abnormal.The serum AST,CK,CKMB and LDH levels were significantly higher in groups A and B than in group C(P<0.01),indicating that the cardiac function of officers and soldiers with positive or negative PTSD in the front disaster relief line was impaired.Conclusion Stress disorder can lead to abnormal immune function and enzyme metabolism in myocardium of those with PTSD.
Objective To analyze the immune function and myocardium enzyme in officers and soldiers of a division who developed stress disorder when they were helping the people to tide over the disaster in Wenchuan earthquake area,and to evaluate their mental and physical health.Methods The officers and soldiers were divided into positive post-traumatic stress disorder(PTSD) group(A),negative PTSD group(B),and normal control group(C).Their T,B,and NK lymphocyte subpopulations were detected and their myocardium enzyme levels including AST,CK,CKMB and LDH were measured,which were compared with those in the normal control group.Results The immune function was with normal range in 3 groups.The number of CD3+ and CD3+ CD4+ T lymphocytes was greater in group A than in group B,and was smaller in group B than in group C(P<0.01).The number of CD4/CD8 T lymphocytes was smaller in groups A and B than in group C(P<0.01).The number of CD19+ B lymphocytes was significantly smaller in group A than in group B(P<0.05).The number of CD19+ B lymphocytes in group B and the number of CD3-CD56+ NK lymphocytes in group A were significantly greater than in group C(P<0.01),indicating that the immune function of the officers and soldiers was abnormal.The serum AST,CK,CKMB and LDH levels were significantly higher in groups A and B than in group C(P<0.01),indicating that the cardiac function of officers and soldiers with positive or negative PTSD in the front disaster relief line was impaired.Conclusion Stress disorder can lead to abnormal immune function and enzyme metabolism in myocardium of those with PTSD.
引文
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6高艳红,于青琳,田亚平,等.不同因素对舰艇官兵细胞免疫功能的影响[J].解放军医学杂志,2008,33(2):226-228.
2Taylor HR,Freeman MK,Cates ME.Prazosin for treatment of nightmares related to posttraumatic stress disorder[J].Am J Health Syst Pharm,2008,65(8):716-722.
3Yehuda R,Bierer LM,Schmeidler J,et al.Low cortical and risk for PTSD in adult offspring of holocaust survivors[J].Am J Psychiatry,2000,157(8):1252-1259.
4Watson IP,Muller HK,Jones IH,et al.Cell-mediated immunity in combat veterans with post-traumatic stress disorder[J].Med J Aust,1993,159(8):513-516.
5Boscarino JA,Chang J.Higher abnormal leukocyte and lymphocyte counts20years after exposure to severe stress:research and clinical implication[J].Psychosom Med,1999,61(3):378-386.
6高艳红,于青琳,田亚平,等.不同因素对舰艇官兵细胞免疫功能的影响[J].解放军医学杂志,2008,33(2):226-228.
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