复发性流产患者心理因素的研究及其对免疫功能的影响

发布时间：2018-01-01 14:14

本文关键词：复发性流产患者心理因素的研究及其对免疫功能的影响　出处：《兰州大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的研究早期复发性流产(recurrent abortion)患者的情绪状态、影响因素以及患者的细胞免疫功能,分析情绪状态对患者细胞免疫功能的影响,从而为临床心理干预治疗早期复发性流产提供新的理论依据。方法随机选取2009年3月～2009年12月在甘肃省妇幼保健院生殖免疫中心就诊的120例早期复发牲流产患者作为研究组,同期111例正常已婚育健康育龄妇女为对照组,应用抑郁自评量表(Self—Rating Depression Scale,SDS)和焦虑自评量表(Self—Rating Anxiety Scale,SAS)测评两组的焦虑、抑郁状态,同时应用流式细胞仪监测两组的细胞免疫功能——CD3+T淋巴细胞总数、CD3+CD4+T、CD3+CD8+T细胞、CD4+CD25+调节性T细胞(CD4+CD25+ Tr,Treg)及自然杀伤细胞CD56+CD16+(CD56+CD16+NK)的含量,并计算CD4+/CD8+比值,分析复发性流产患者情绪状态、影响因素,以及情绪状态与细胞免疫功能的关系。结果 1、研究组及对照组的焦虑、抑郁结果如下：研究组焦虑的发生率为69.1%,中重度占14.1%,对照组焦虑的发生率为11.7%,中重度占1.8%(χ2=78.703,P0.01)；研究组抑郁的发生率为37.4%,中重度占11.6%,对照组抑郁的发生率为6.3%,中重度占1.8%(χ2=32.338,P0.01),均有统计学意义。 2、经Pearson相关分析显示研究组焦虑、抑郁情绪分别与患者年龄、流产次数及文化程度呈正相关(相关系数依次为r=0.781、0.901,P0.01；r=0.808、0.861,P0.01;r=0.644、0.782,P0.01)。 3、研究组外周血CD3+CD8+T细胞低于对照组(t=7.467 P0.01),而CD4+/CD8+比值较对照组明显增高(t=5.248 P0.01)；研究组外周血CD4+CD25+Tr含量低于对照组(t=-27.091 P＜0.01);CD56+CD16+NK细胞明显高于于对照组(t=5.979 P0.01)；差异均有统计学意义。 4、经Pearson相关分析显示研究组焦虑、抑郁程度与CD4+／CD8+比值呈正相关(r=0.201,P＜0.05;r=0.223、P＜0.05);与CD56+CD 16+NK细胞呈正相关(r=0.181,P＜0.05;r=0.214、P＜0.05);与CD4+CD25+Tr细胞相关性无统计学意义(r=-0.080,P=0.929:r=0.033.P=0.718)。结论 1、复发性流产患者焦虑、抑郁的发生率明显高于正常育龄期妇女。 2、复发性流产与社会心理因素有一定相关性。本研究调查发现年龄大、高学历、流产次数多的患者焦虑、抑郁程度重。 3、复发性流产患者焦虑、抑郁程度与外周血淋巴细胞亚群变化的相关性提示患者的情绪因素影响机体的细胞免疫功能,也是引起复发性流产的重要原因。
[Abstract]:Objective to study the emotional state, influencing factors and cellular immune function of patients with early recurrent abortion. To analyze the effect of emotional state on the cellular immune function of patients, and to provide a new theoretical basis for clinical psychological intervention in the treatment of early recurrent abortion. Methods from March 2009 to December 2009, 120 patients with early recurrent abortion were randomly selected as the study group in the Reproductive Immunization Center of the Maternal and Child Health Hospital of Gansu Province. In the same period, 111 normal married and healthy women of childbearing age were used as control group. Self-Rating Depression Scale was used. Self rating Anxiety scale (SAS) and self rating Anxiety scale (SAS) were used to evaluate the anxiety and depression status of the two groups. At the same time, flow cytometry was used to monitor the cellular immune function of the two groups: the total number of CD3 T lymphocytes, CD3 CD4, CD3 CD8 T cells. CD4 CD25 regulatory T cell CD 4 CD25 Tri Treg) and natural killer cell CD56 CD16 CD56 CD16 NKK. The CD4 / CD8 ratio was calculated to analyze the emotional state, influencing factors, and the relationship between emotional state and cellular immune function in patients with recurrent abortion. Results 1. The results of anxiety and depression in the study group and the control group were as follows: the incidence of anxiety in the study group was 69.1, the incidence of moderate and severe anxiety was 14.1, and the incidence of anxiety in the control group was 11.7%. The proportion of moderate to severe was 1.8 (蠂 ~ 2 = 78.703) (P = 0.01); The incidence of depression in the study group was 37.4, moderate to severe was 11.6. In the control group, the incidence of depression was 6.3 and 1.8in the control group (蠂 ~ 2, 32.338n, P 0.01). All had statistical significance. (2) Pearson correlation analysis showed that anxiety and depression were positively correlated with age, abortion frequency and education level in the study group (r = 0.781 卤0.901). P0.01; RH 0.808, 0.861, P0.01; Rhizoma 0.644L 0.782P0.01. 3The CD3 CD8 T cells in peripheral blood of the study group were lower than that of the control group (7.467, P 0.01). The ratio of CD4 / CD8 was significantly higher than that of the control group. The level of CD4 CD25 Tr in the study group was lower than that in the control group (P < 0.01). The NK cells of CD56 CD16 were significantly higher than those of the control group (5.979 P 0.01). The difference was statistically significant. 4. Pearson correlation analysis showed that there was a positive correlation between anxiety, depression and CD4 / CD8 ratio in the study group (P < 0.05). P < 0.05; There was a positive correlation with CD56 CD16 NK cells (P < 0.05). R = 0.214 (P < 0.05); There was no significant correlation with CD4 CD25 Tr cells. Conclusion 1. The incidence of anxiety and depression in recurrent abortion patients was significantly higher than that in normal childbearing age women. 2, recurrent abortion has certain correlation with psychosocial factors. This study found that the patients with older age, higher education and more times of abortion had serious anxiety and depression. 3. The correlation between anxiety, depression and peripheral blood lymphocyte subsets in patients with recurrent abortion suggests that the emotional factors affect the cellular immune function of the body and are also the important causes of recurrent abortion.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R395

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