战争后应激障碍与认知功能障碍及睡眠质量关系的研究  

The Relationship between Post-war Stress Disorder and Cognitive Dysfunction and Sleep Quality

作　　者：刘冬[1] 陶永[2] 蒋晓江[2] 严家川[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所创伤外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《解放军医药杂志》2015年第11期48-51,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：军队保健课题(2012BJZ51)

摘　　要：目的探讨战争应激心理障碍对参战人员睡眠质量及认知功能的影响。方法选择20世纪70年代参加过西南边境作战的军队退休干部47人为研究组,选择没有参战的军队退休干部49人为对照组。采用症状自评量表(SCL-90)评定两组心理健康水平;观察研究组心理症状与认知功能[采用简易精神状态检查量表(MMSE)评定]、脑白质病变(行头颅MR检查观察)及睡眠障碍[采用匹兹堡睡眠质量指数量表(PSQI)评定]的关系。结果研究组有13例(27.7%)SCL-90心理症状筛查阳性,躯体化、强迫症状、抑郁、焦虑、恐怖、精神病性6个因子分及总分显著高于对照组(P<0.05)。研究组心理症状筛查阳性者与心理症状筛查阴性者比较,认知功能下降者比例显著升高(P<0.05)、MMSE总分显著降低(P<0.05),脑白质病变发生率显著升高(P<0.05),睡眠障碍发生率显著升高(P<0.05),PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍因子分及总分均显著升高(P<0.05)。结论战争应激所致参战人员的心理障碍较重且影响持久,应予关注,及时采取针对性心理干预措施,以最大限度保障其身心健康。Objective To investigate the effect of post-war psychological stress disorder on sleep quality and cognitive function of war participants. Methods A total of 47 PLA retired officers, who had taken part in the war at the southwest border in the 1970s, were selected as the research group, while 49 military retired officers who did not take part in the war were selected as control group. The levels of mental status in the two groups were evaluated with the symptom checklist-90 （SCL-90） ; the relationships between mental symptoms and cognitive function [ measured with mini-mental state examination （MMSE） ] , encephalic white matter lesions [ evaluated with brain magnetic resonance （MR） ] as well as sleep disorders [ measured with Pittsburgh sleep quality index （PSQI） ] in the research group were also analyzed. Re- suits In the research group, the positive mental symptom was found in 13 cadres （27.7%） measured by SCL-90, and scores of somatization, obsessive-compulsive, depression, anxiety, terror and psychotic factors and the total score were significantly higher than those in the control group （P 〈 0.05 ）. In the research group, the ratio of positive mental symp- tom officers with cognitive decline was significantly higher （P 〈 0.05 ） , while the total score of MMSE was significantly lower than those with negative mental symptom officers （P 〈 0. 05 ） ; the incidence rate of eneephalic white matter lesions of positive mental symptom officers was significantly higher compared with those of negative mental symptom officers （ P 〈 0.05） ; the incidence rate of officers with sleep disorders of positive mental symptom officers was significantly higher than that of negative mental symptom officers （ P 〈 0.05 ） , and the scores of sleep quality, time of falling sleep, hours of sleep, sleep efficiency, sleep disorder, daytime dysfunction factors and total score of PSQI of positive mental symptom of- ricers were significantly higher than those of negative mental symptom officer

关 键 词：战争应激 心理障碍 睡眠质量 认知功能 脑白质病变 

分 类 号：R828.74[医药卫生—临床医学]