乳腺癌患者心理社会因素与免疫功能的变化及其相关性  

Study on the Change and Correlation between Psychosocial Factor and Immunity Function in Breast Cancer Patients

作　　者：龚蕉椒[1] 周颖清[1] 吴凯南[1] 许玮[1] 

机构地区：[1]重庆医科大学护理学院,重庆市400016

出　　处：《中国全科医学》2008年第10期838-840,共3页Chinese General Practice

摘　　要：目的探讨乳腺癌患者心理社会因素和免疫功能的变化及两者间的相关性。方法采用社会支持评定量表(SSRS)、艾森克人格问卷(EPQ)、简易应对方式问卷、汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)对60例乳腺癌患者进行评定;另采用SSRS、EPQ、简易应对方式问卷评定30例健康人群。用碱性磷酸酶桥联酶标法测定乳腺癌患者和健康人群外周血T细胞亚群。结果乳腺癌组SSRS总分、对支持的利用度分低于健康对照组(P<0·05);简易应对方式量表的消极应对分、EPQ-N、EPQ-L评分高于对照组(P<0·05)。乳腺癌患者抑郁和焦虑评分与分期分别呈正相关;乳腺癌患者焦虑与抑郁呈正相关;积极应对评分与社会支持利用度呈正相关;EPQ-E评分与积极应对评分、社会支持利用度评分分别呈正相关;EPQ-N评分与消极应对评分呈正相关。乳腺癌患者的免疫功能较健康人群低下,其中CD3+、CD4+、CD4+/CD8+低于对照组,CD8+高于对照组,差异有统计学意义(P<0·01)。CD3+、CD4+、CD4+/CD8+与患者的分期呈负相关;CD8+与患者的分期呈正相关;CD3+、CD4+与焦虑呈负相关;CD8+与焦虑呈正相关(P<0·001);CD3+、CD4+与抑郁呈负相关(P<0·001);CD8+与抑郁呈正相关(P<0·001);CD4+与EPQ-N评分呈负相关(P<0·05);CD8+与EPQ-N评分呈正相关(P<0·05)。结论乳腺癌患者心理社会因素与免疫系统之间有着密切的联系,心理社会因素作用于免疫系统影响着肿瘤的发生与发展。Objective The present study was designed to investigate the change and correlation between psychosocial factors and immune system of breast cancer patients. Thus, theory basis to psychotherapy of breast cancer patients can be provided. Methods The patients of breast cancer （60 cases） were measured by psychological rating scale （ HAMA, HAMD, SSRS, EPQ, simplified coping style questionnaire）. The health controls （30 cases） were measured by the later three scales. The positive rate of CD3^＋, CD4^＋, CD8^＋ and the ratio of CD4^＋/CD8^＋ in the peripheral blood of breast cancer patients were measured by APAAP. Results In breast cancer group, there were significantly lower scores of social suppores and utility degree of supports; while the score of passive coping, N score of EPQ, L score of EPQ were marked higher. The higher stage was, the higher score of anxiety and depression in breast cancer patients was. There were significantly correlation between anxiety and depression in breast cancer group, so were the scores of positive coping and utility degree of supports, E score of EPQ and positive coping, E score of EPQ and utility degree of supports, N score of EPQ and passive coping. The immune function had a significant decrease in breast cancer patients. The positive rate of CD3^＋ , CD4^＋ and the ratio of CD4^＋/CD8^＋ were significantly decreased than controls while CD8^＋ was higher than control group. The higher stage was, the higher positive rate of CD3^＋, CD4^＋ and the ratio of CD4^＋/CD8^＋ were while the lower positive rate of CD8^＋ was. There were significantly correlation between the positive rate of CD3^＋ , CD4^＋ and anxiety, so was the positive rate of CD8^＋ and anxiety; the positive rate of CD3^＋ , CD4^＋ and depression, the positive rate of CD8^＋ and depression; the positive rate of CD4^＋ and N score of EPQ ; the positive rate of CD8^＋ and N score of EPQ. Conclusion There are significant correlations between psychosocial factors and immunity systems of brea

关 键 词：乳腺肿瘤 心理学 社会 T淋巴细胞 

分 类 号：R737.9[医药卫生—肿瘤]