广西白裤瑶聚居地区不同民族人群心理应激状况及环境和遗传影响因素的研究

发布时间：2018-07-31 08:49

【摘要】：目的(1)了解广西白裤瑶聚居地区不同民族人群的心理应激及相关心理行为状况。(2)探索基因COMT、NPSR1、HSP90B1、HSP90AA2、FKBP5的基因多态性与广西白裤瑶聚居地区的不同民族人群心理应激及相关心理特征的关系。(3)分析影响广西白裤瑶聚居地区的不同民族人群心理应激的社会(环境)与遗传作用以及之间的关系。方法(1)采取分层随机整群抽样的方法,分别随机抽取广西南丹县白裤瑶族聚集地区里湖乡、八圩乡2个白裤瑶族村以及壮族与汉族杂居地2个村,单纯随机抽取18岁以上的白裤瑶族193人、壮族200人和汉族186人,共579名村民作为研究对象。(2)采用自编一般人口学、心理应激相关行为因素问卷进行人口学特征和应激相关行为调查。(3)对调查对象进行身高、体重、腰围、臀围、腹围、心率、血压等体格检查和TC、TG、HDLC和LDLC生化指标检测。(4)采用心理测量工具生活事件量表、简化心身症状自评量表、简易应对方式问卷、社会支持评定量表调查心理应激及相关心理特征。(5)采用iMLDR法对COMT基因的rs6267、rs769224、rs4680、NPSR1基因的rs12673132、rs6947841、rs324981、rs6972158,HSP90B1基因的rs17034977,HSP90AA2基因的rs2726836以及FKBP5基因的rs1360780、 rs3800373共11个位点SNP分型检测。(6)采用SPSS19.0统计软件、Amos5.0统计分析软件进行数据分析。应用t检验或卡方检验比较不同人口学特征之间应激相关的心理行为和基因型、等位基因的分布。应用Amos5.0构建结构方程,分析(社会)环境与心理应激发生的关系。通过单因素和多因素logistic回归分析(社会)环境因素、基因多态性与心理应激发生风险的关系。结果(1)总体生活事件量表得分第百分五十分位数(P50)是27分,总分≥20分的有293人次,阳性率50.60%。其中,家庭事件、工作事件和社交事件的发生频率分别为75.82%、11.57%和24.35%。发生频率排在前三位的生活事件分别是家庭经济困难234,人次(40.41%)、欠债133人次(22.97%)、住房紧张96人次(16.58%)。(2)总体心理症状总分44.39±13.16,范围是29-110,总体阳性率13.82%。四个因子均分分别是躯体化1.75±0.63、焦虑1.47±0.58、抑郁1.51±0.58、敌对1.32±0.45；三个民族的心理因子的阳性率在8.00%-34.48%之间。焦虑因子在三个民族和总体之间差异有统计学意义(P0.05)；与全国常模比较,三个民族的躯体化因子均高于常模,白裤瑶族的焦虑高于全国常模,敌对低于常模；壮族的敌对因子低于全国常模。(3)总体应对方式总分40.93±10.95,其中积极应对为25.61±8.10；消极应对为15.32±4.39。汉族的积极应对分最高,壮族其次,白裤瑶族最低。三个民族消极应对、积极应对均高于全国常模。(4)总体社会支持总分27.72±6.07；其中主观支持为12.57±3.09；客观支持为8.24±2.60；支持利用度为6.91±2.42,汉族的主观支持高于壮族。与壮族常模比较,三个民族的社会支持总分、主观支持和社会支持利用度均小于常模；客观支持则高于常模。(5)筛查的5个基因的11个基因位点的基因型和等位基因分布情况,NPSRlrs12673132位点的等位基因G/A,NPSR1rs6947841的等位基因C/T在性别之间差异有统计学意义(P0.05)。对不同民族的基因型和基因分布情况进行比较,除了NPSRlrs324981的基因型和等位基因、HSP90BIrs17034977和HSP90AA2rs2726836的等位基因在三个民族之间差异无统计学意义外(P0.05),其他基因位点的基因型和基因位点在三个民族之间差异均有统计学意义(P0.05)。(6)以生活事件总分≥20分为心理应激阳性,对筛查基因位点的生活事件阳性/阴性分组的基因型和等位基因分布进行比较,白裤瑶族、汉族人群未发现两组之间差异；壮族人群COMTrs4680的基因型；NPSRlrs324981的基因型和等位基因,FKBP5rs1360780的基因型分别在两组差异有统计学意义(P0.05)。(7)以心理症状因子分≥2分为心理症状阳性,对筛查基因位点的心理症状阳性/阴性分组的基因型和等位基因分布进行比较,白裤瑶族人群的焦虑因子两组比较中发现FKBP5rs1360780和FKBP5rs3800373的基因型和等位基因分布差异有统计学意义(P0.05)。在壮族人群中,COMTrs769224、NPSR1rs6947841、NPSR1rs6972158位点的基因型在焦虑因子两组间差异有统计学意义(P0.05)；FKBP5rs1360780的等位基因在抑郁因子两组间差异有统计学意义(P0.05)。对汉族人群的HSP90AA2rs2726836等位基因在躯体化因子两组问差异有统计学意义(P0.05)。NPSR1rs324981的等位基因在抑郁因子两组间差异有统计学意义(P0.05)。COMTrs769224的基因型和等位基因、HSP90AA2rs2726836的等位基因在敌对因子两组间差异有统计学意义(P0.05)。(8)对不同应对方式分组的基因型和等位基因进行比较,汉族的NPSR1rs6972158等位基因分布差异有统计学意义(P0.05)。利用多元方差模型分析,对白裤瑶族、壮族和汉族的筛查基因位点的主观支持、客观支持和支持利用度进行比较,三个维度之间差异无统计学意义(P0.05)。(9)应用单因素Logistic回归分析全体调查对象不同基因型与心理应激(生活事件阳性)发生的危险性,结果发现以NPSRl基因rs324981位点AA基因型为参照,携带TT基因型者发生心理应激的风险降低0.445(95%CI：0.234-0.844)倍,差异有统计学意义(P0.05)。(10)应用多因素Logistic回归分析结果显示,躯体化、焦虑和抑郁三个心理症状使心理应激发生风险分别增加2.381倍(95%CI:1.554-3.649),2.017倍(95%CI：1.148-3.544)和1.845倍(95%CI：1.053-3.230),差异均有统计学意义(P0.05)。舒张压和收缩压使心理应激发生风险分别为0.981倍(95%CI:0.968-0.995)和1.025倍(95%CI：1.003-1.048),差异均有统计学意义(P0.05)。结论(1)广西白裤瑶族聚居地区人群总体生活事件阳性率较高,引起心理应激的事件以家庭事件为主。(2)研究对象总体心理症状阳性率处在正常范围,焦虑水平在三个民族之间具有差异；三个民族的躯体化以及白裤瑶族的焦虑程度较全国平均水平高,两少数民族的敌对程度均低于平均水平。三个民族消极应对、积极应对均高于全国水平,汉族的积极应对最多见。三个民族的社会支持总分、主观支持和社会支持利用度低于壮族平均水平；客观支持则较高。(3)NPSRlrs12673132、rs6947841基因位点的基因型或等位基因存在性别差异。COMTrs6267、rs769224、rs4680, NPSR1rs12673132、rs324981、 rs6972158以及FKBP5rsl360780、rs3800373基因位点的基因型或等位基因存在民族差异。(4)筛查选取的FKBP5 rs1360780、rs3800373,C0MT rs4680.769224, NPSR1 rs324981、rs6947841、rs6972158, HSP90AA2rs2726836基因位点多态性分布在不同民族的生活事件、心理症状、应对方式中体现出差异。(5) NPSR1rs324981基因位点携带T等位基因的基因型可能是心理应激发生的保护性基因型。躯体化、焦虑和抑郁心理症状和收缩压升高是心理应激发生的危险因素；舒张压降低是心理应激发生的保护因素。
[Abstract]:Objective (1) to understand the psychological stress and related psychological behavior of different ethnic groups in the habitation area of Guangxi Bai Ku Yao. (2) explore the genetic polymorphisms of gene COMT, NPSR1, HSP90B1, HSP90AA2, FKBP5 and the psychological stress and psychological characteristics of different ethnic groups in the habitation area of Guangxi Bai Ku Yao. (3) analysis of the influence of Guangxi Bai Ku Yao settlement The relationship between the social (environment) and the heredity and the relationship between the psychological stress of different ethnic groups in the region. Method (1) the method of stratified random cluster sampling was adopted to randomly select the Guangxi Nandan County white trousers and Yao Nationality Area Li Hu Township, the 2 white trousers and Yao Ethnic Villages in eight polder villages and the 2 villages of the Zhuang and Han Hans, which were randomly selected for 18 years of age. 193 people of Bai Ku Yao, 200 Zhuang and 186 Han people, 579 villagers were studied as subjects. (2) a survey of demographic characteristics and stress related behavior was conducted by self-made general demography and psychological stress related behavioral factors questionnaire. (3) body height, weight, waist circumference, hip circumference, heart rate, blood pressure, and other physical examinations and TC, TG, HDLC and LDLC biochemical indexes. (4) the psychometric tool life events scale was used to simplify the self rating scale of psychosomatic symptoms, simple coping style questionnaire, and social support rating scale to investigate psychological stress and related psychological characteristics. (5) rs6267, rs769224, rs4680, rs12673132, rs6947841, rs324981, COMT gene, rs6267, rs769224, rs4680, and the iMLDR method were used. Rs6972158, HSP90B1 gene rs17034977, HSP90AA2 gene rs2726836 and FKBP5 gene rs1360780, rs3800373 altogether 11 loci SNP typing. (6) SPSS19.0 statistical software, Amos5.0 statistical analysis software for data analysis. Using t test or chi square test to compare the stress related psychological behavior between different demographic characteristics and the difference between the psychological behavior and the The distribution of genotypes and alleles. Structure equations were constructed with Amos5.0, and the relationship between (SOCIAL) environment and psychological stress was analyzed. The relationship between genetic polymorphism and the risk of psychological stress was analyzed by single factor and multiple factor Logistic regression analysis (SOCIAL). Results (1) the score of the total life event scale was fifty. P50) was 27. There were 293 people with a total score of more than 20. The positive rate was 50.60%.. The frequency of family events, work events and social events were 75.82%, 11.57% and 24.35%., respectively, were 234, 40.41%, 22.97%, 96 (16.58%). (16.58%). (2) The total score of the total psychological symptoms was 44.39 + 13.16, with a range of 29-110. The total positive rate of 13.82%. four factors was 1.75 + 0.63, anxiety 1.47 + 0.58, depression 1.51 + 0.58 and hostile 1.32 0.45, and the positive rate of psychological factors of three nationalities was between 8.00%-34.48%. P0.05, compared with the national norm, the somatization factors of the three ethnic groups were all higher than the norm, and the anxiety of the Bai Ku Yao was higher than the national norm and the enemy was lower than the norm. The antagonism factor of the Zhuang nationality was lower than the national norm. (3) the total coping style was 40.93 + 10.95, of which the positive should be 25.61 + 8.10, and the negative coping was 15.32 + 4.39. Han Han. Coping with the highest score, the second of Zhuang nationality, white pants Yao was the lowest. Three ethnic negative responses were higher than the national norm. (4) the total social support score was 27.72 + 6.07, the subjective support was 12.57 + 3.09, the objective support was 8.24 + 2.60, the support utilization was 6.91 + 2.42, and the subjective support of the Han nationality was higher than the Zhuang. Compared with the Zhuang normal model, three. The subjective support and social support utilization are less than the norm, and the objective support is higher than the norm. (5) the genotype and allele distribution of the 11 gene loci of the 5 genes of the screening, the allele G/A of the NPSRlrs12673132 site and the NPSR1rs6947841 allele C/T are statistically different among the sexes. Study significance (P0.05). Compared with the genotype and gene distribution of different nationalities, the alleles of HSP90BIrs17034977 and HSP90AA2rs2726836 are not statistically significant between the three ethnic groups except the genotype and allele of NPSRlrs324981 (P0.05), and the genotypes and loci of the other gene loci are between the three nationalities. The difference was statistically significant (P0.05). (6) the total score of the life events was more than 20, and the genotype and allele distribution of the positive / negative group were compared. The white pants Yao nationality, the Han population did not find the difference between the two groups; the COMTrs4680 genotypes of the Zhuang population; NPSRlrs324981 Genotypes and alleles, the genotypes of FKBP5rs1360780 were statistically significant in the two groups (P0.05). (7) the psychological symptom factor was more than 2 of the mental symptoms positive, and the genotype and allele distribution of the positive / negative group of the screening gene locus were compared, and the two groups of anxiety factors of the Bai pants Yao population were compared. There was significant difference in the distribution of genotypes and alleles between FKBP5rs1360780 and FKBP5rs3800373 (P0.05). In the Zhuang population, the genotype of COMTrs769224, NPSR1rs6947841 and NPSR1rs6972158 loci were statistically significant between the two groups of anxiety factors (P0.05); FKBP5rs1360780 alleles were among the two groups of depressive factors. The difference was statistically significant (P0.05). The HSP90AA2rs2726836 alleles of the Han population were statistically significant in the two groups of somatization factors (P0.05).NPSR1rs324981 alleles were statistically significant in the two groups of depressive factors (P0.05).COMTrs769224 genotypes and alleles, HSP90AA2rs2726836 alleles were in a statistical significance The differences between the two groups were statistically significant (P0.05). (8) the genotype and alleles of different coping styles were compared, and the distribution of NPSR1rs6972158 alleles in the Han nationality was statistically significant (P0.05). The subjective support of the screening gene loci of Bai Ku Yao nationality, Zhuang and Han nationality was analyzed by multivariate variance model. The difference between the three dimensions was not statistically significant (P0.05). (9) a single factor Logistic regression was used to analyze the risk of different genotypes and psychological stress (positive life events) in all the subjects, and the results were found to carry the TT genotype in the NPSRl based rs324981 locus AA genotype. The risk of psychological stress decreased by 0.445 (95%CI:0.234-0.844), and the difference was statistically significant (P0.05). (10) the results of multiple factor Logistic regression analysis showed that the three psychological symptoms of somatization, anxiety and depression increased the risk of psychological stress by 2.381 times (95%CI:1.554-3.649), 2.017 times (95%CI:1.148-3.544) and 1.845 times (95%C). I:1.053-3.230), the difference was statistically significant (P0.05). The risk of diastolic and systolic pressure was 0.981 times (95%CI:0.968-0.995) and 1.025 times (95%CI:1.003-1.048) respectively. The difference was statistically significant (P0.05). Conclusion (1) the positive rate of overall life events in the population of Guangxi Bai Ku Yao people was higher, causing psychological stress. The most exciting events are family events. (2) the positive rate of the overall psychological symptoms of the study is in the normal range, and the level of anxiety is different among the three ethnic groups; the somatization of the three ethnic groups and the anxiety of the Bai Ku Yao are higher than the national average, and the enemy pairs of the two ethnic minorities are lower than the average level. Three ethnic groups should be negative. The positive response was higher than the national level. The positive response of the Han people was the most common. The total social support score of the three ethnic groups, the subjective support and the social support utilization were lower than the average level of the Zhuang, and the objective support was higher. (3) NPSRlrs12673132, the genotype or allele of the rs6947841 gene locus had sex differences.COMTrs6267, rs769224, rs468. 0, NPSR1rs12673132, rs324981, rs6972158, and FKBP5rsl360780, there are ethnic differences in genotype or allele of rs3800373 gene loci. (4) screening selected FKBP5 rs1360780, rs3800373, C0MT rs4680.769224, NPSR1 rs324981, polymorphism distribution in different ethnic groups. Differences in psychological symptoms and coping styles. (5) the genotype of NPSR1rs324981 allele carrying T allele may be a protective genotype of psychological stress. Somatization, anxiety and depression and elevated systolic pressure are the risk factors for psychological stress; diastolic pressure is a protective cause of psychological stress. Prime.
【学位授予单位】：广西医科大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：B844;R195

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