乳腺癌患者围手术期心理应激与免疫功能的关系  

Relationship between psychological stress and immune function in patients with breast cancer during perioperative period

作　　者：王艳英[1] 马玉磊[2] 管艳杰[3] 李文妍[4] 高玲[5] 

机构地区：[1]潍坊市妇幼保健院乳腺外科,山东潍坊261011 [2]潍坊医学院附属医院ICU病房,山东潍坊261031 [3]潍坊医学院附属医院康复实验室,山东潍坊261031 [4]潍坊市妇幼保健院普通外科,山东潍坊261011 [5]潍坊市妇幼保健院感染管理科,山东潍坊261011

出　　处：《中国妇幼保健》2017年第17期4099-4103,共5页Maternal and Child Health Care of China

基　　金：潍坊市科学技术进步奖项目(JB28901)

摘　　要：目的研究乳腺癌患者围手术期心理应激与免疫功能的关系。方法选择2014年1月-2017年1月在该院接受手术治疗的乳腺癌患者87例作为观察组,另选同期在该院接受健康体检的女性志愿者85例作为对照组,术前及术后7 d对观察组进行症状自评量表(SCL-90)评分及免疫功能检测。对照组仅在入组时进行SCL-90评分和免疫功能检测。对比两组SCL-90心理应激相关指标评分以及免疫功能相关指标,并采用Spearman相关性分析患者围手术期的心理应激与免疫功能指标的相关性。结果观察组术后7 d的SCL-90各项评分(躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性以及SCL-90总分)均分别显著低于术前,差异均有统计学意义(P<0.05)。观察组术前及术后7 d的SCL-90各项评分均分别显著高于对照组,差异均有统计学意义(P<0.05)。观察组术前及术后7 d的CD3^+、CD4^+及CD8^+均分别显著低于对照组,差异均有统计学意义(P<0.05)。观察组术后7 d的CD3^+及CD4^+均分别显著高于术前,差异均有统计学意义(P<0.05)。根据Spearman法分析相关性发现,患者围手术期的心理应激SCL-90评分与CD3^+和CD4^+呈负相关(P<0.05),而与CD8^+及CD4^+/CD8^+无明显的相关性(P>0.05)。结论乳腺癌患者在围手术期的心理应激状态较强,免疫功能较低,两者之间存在紧密联系,且患者的SCL-90评分与CD3^+和CD4^+呈负相关,临床可考虑进行相应的心理干预。Objective To study the relationship between psychological stress and immune function in patients with breast cancer during perioperative period.Methods A total of 87 patients with breast cancer who received surgical treatment in the hospital from January 2014 to January 2017 were selected as observation group,and 85 female volunteers receiving health physical examination in the hospital during the same period were selected as control group.Sympton Check List 90 （SCL-90） and immune function were detected in observation group before operation and at 7 days after operation.In control group,SCL-90 and immune function were detected only when they were enrolled.SCL-90 scores of psychological stress-related indicators and immune function-related indicators in the two groups were compared.Spearman correlation analysis was used to analyze the correlation between psychological stress and immune function indicators in patients during perioperative period.Results In observation group,the scores of each items of SCL-90 （including somatization,obsessive-compulsive symptom,interpersonal relationship,depression,anxiety,hostility,phobia,paranoia,psychosis） and the total score of SCL-90 at 7 days after operation were statistically significantly lower than those before operation （P〈0.05）.The scores of each items of SCL-90 in observation group before operation and at 7 days after operation were statistically significantly higher than those in control group （P〈0.05）.The average levels of CD3＋,CD4＋,and CD8＋ in observation group before operation and at 7 days after operation were statistically significantly lower than those in control group （P〈0.05）.The average levels of CD3＋ and CD4 ＋ in observation group at 7 days after operation were statistically significantly higher than those before operation （P〈0.05）.Spearman correlation analysis showed that SCL-90 score was negatively correlated with CD3＋ and CD4＋,respectively （P〈0.05） in patients during perioperative period,while there was no

关 键 词：乳腺癌 围手术期 心理应激 免疫功能 关系 

分 类 号：R737.9[医药卫生—肿瘤]