军事应激对新兵消化道疾病相关激素水平的影响  

Correlation between the recruits' gastrointestinal hormon level and military stress

作　　者：许涛[1] 李兆申[1] 彭国林[1] 范群铭[1] 黄文[1] 

机构地区：[1]第二军医大学长海医院野战内科研究所,上海200433

出　　处：《解放军医学杂志》2007年第3期193-195,共3页Medical Journal of Chinese People's Liberation Army

基　　金：军队"2110工程"重点建设学科--野战内科学(0301)

摘　　要：目的探讨新兵军事应激条件下消化道疾病相关激素水平的变化。方法对150名新兵进行消化道症状问卷调查和心理调查(SCL-90量表),放射免疫法检测实弹射击前后血清胃泌素、血管活性肠肽(VIP)、皮质醇、β-内啡肽(β-EP)浓度,并在实弹射击训练后对所有新兵行胃镜、B超检查以及幽门螺杆菌(Hp)检测。结果150名新兵中实弹训练后胃镜检查发现糜烂性胃炎和消化性溃疡17例,Hp感染率为62.7%(94/150),高于普通人群Hp感染率(55%,P<0.05)。实弹训练后血清胃泌素、VIP、皮质醇及β-EP浓度均较实弹射击前显著升高(P<0.01),糜烂性胃炎/消化性溃疡组的血清胃泌素水平显著高于基本正常组(P<0.05),而VIP水平两组无显著差异。SCL-90≥160分组血清皮质醇浓度显著高于SCL-90<160分组,且SCL-90总分与皮质醇浓度呈正相关(P<0.05),而β-EP浓度两组无显著差异。结论军事心理应激可能引发或加重胃肠道疾病以及引起血清胃泌素、VIP、皮质醇、β-EP水平升高;消化性溃疡及胃黏膜糜烂的发生与胃泌素分泌增多有关,血清胃泌素的变化可能是心理应激过程中的继发改变,不同的心理状态可能对应激情况下胃泌素的分泌产生一定影响。Objective To investigate the correlation between the recruits＇ gastrointestinal hormone level and military stress. Methods 150 army recruits were included for the study. The gastrointestinal symptom and mental status of army recruits were investigated with questionnaires as well as Symptom Checklist 90 （SCL-90）. Serum gastrin, vasoactive intestinal peptide （VIP）, cortisol, β-endorphine （β- EP） levels were determined with radioimmunological techniques before and after live ammumition shooting training. All the army recruits underwent endoscopic and abdominal uhrasonographic examinations, and the presence of Helicohacter pylori （Hp） was detected by rapid urease test （RUT）. Results 17 army recruits developed erosive gastritis or peptic ulcer after shooting training. Hp was detected in 94 army recruits （62. 7%）, the infectation rate was significantly higher than that of normal people （55%, P〈0. 05）. The serum gastrin, VIP, cortisol and β-EP level of all the recruits were significantly elevated after shooting training. The gastrin level of army recruits that developed erosive gastritis or peptic ulcer was higher than that of normal army recruits, while no significant difference was found on VIP level between the two groups. Compared with that of SCL-90〈160 group, the serum cortisol level in SCL-90≥160 group was significantly higher. The serum cortisol level was positively correlated with SCL-90. No significant difference in serum gastri, VIP and β-EP levels was found between the two groups. Conclusion Military psychological stress may initiate, even aggravate the gastrointestinal diseases, and elevate the levels of serum gastrin, VIP, cortisol and β-EP. The incidences of peptic ulcer and gastric mucosal erosion were correlated with increased gastrin secretion. The changes in gastrin secretion level may be a secondary event, and mental status may exert an influence on the gastrin secretion in stress condition.

关 键 词：心理学 军事 应激 心理学 胃泌素类 血管活性肠肽 皮质醇 Β内啡肽 

分 类 号：R537.13[医药卫生—内科学]