汶川大地震后女性内分泌紊乱与创伤后应激障碍的相关性调查
|
摘要
目的探讨汶川大地震后女性内分泌紊乱与创伤后应激障碍(PTSD)的相关性,为其临床防治提供有效措施。方法采用横断面调查和队列随访研究方案,收集1 000例汶川大地震后妇女为研究对象,根据是否发生内分泌紊乱分为两组:内分泌失调组477例和内分泌正常组523例。分别采用自制调查量表、PTSD症状清单平民版调查其一般情况和PTSD患病情况,并抽取所有研究对象的外周静脉血,采用ELISA实验测定雌激素与孕激素水平,分析PTSD症状评分与血清激素水平的相关性。结果调查对象中发生内分泌失调477例,占47.7%,内分泌失调组年龄偏大,地震时在建筑物内、房屋倒塌、受伤、掩埋、家庭成员伤亡的发生率偏高,地震后获得居所所需时间更长,食物短缺和药物短缺的比例更高,组间差异均有统计学意义(均P<0.05)。内分泌失调组PTSD发生率和症状评分高于内分泌正常组,血清雌二醇(E_2)、孕激素(P)和卵泡刺激素(FSH)水平低于内分泌正常组,组间差异均有统计学意义(均P<0.05);经相关性分析,PTSD症状评分与血清E_2、P和FSH水平呈直线负相关关系(P<0.05)。结论汶川大地震后女性内分泌紊乱可能是PTSD的信号,应引起重视,做好临床防治工作。
Objective To explore the correlation between female endocrine disorder and posttraumatic stress disorder(PTSD) after Wenchuan earthquake,provide effective measures for clinical prevention and treatment.Methods A cross-sectional survey and a cohort follow-up study were performed among 1000 women after Wenchuan earthquake.All the women were divided into endocrine disorder group(477 women) and normal endocrine group(523 women) according to occurrence of endocrine disorder or not.A self-made questionnaire scale and PTSD symptom checklist were used to investigate general condition and prevalence of PTSD.Peripheral venous blood samples were obtained,ELISA was used to detect the levels of estrogen and progesterone,the correlation between PTSD symptom score and levels of serum hormones was analyzed.Results The incidence rate of endocrine disorder was 47.7%(477 women).The women in endocrine disorder group were older,the incidence rates of staying in buildings,houses collapse,injury,burying,death of family members were higher,the time to obtain a residence was longer after earthquake,the proportion of food and drug shortage was higher,there were statistically significant differences( P<0.05).The incidence rate of PTSD and symptom score in endocrine disorder group were statistically significantly higher than those in normal endocrine group(P<0.05).The levels of serum estradiol(E_2),progestogen(P),and follicle-stimulating hormone(FSH) in endocrine disorder group were statistically significantly lower than those in normal endocrine group(P<0.05).Correlation analysis showed that there were negative linear correlations between PTSD symptom score and levels of serum E_2,P,and FSH(P<0.05).Conclusion Female endocrine disorder after earthquake is likely to be a signal of PTSD,which should be paid more attention to.
Objective To explore the correlation between female endocrine disorder and posttraumatic stress disorder(PTSD) after Wenchuan earthquake,provide effective measures for clinical prevention and treatment.Methods A cross-sectional survey and a cohort follow-up study were performed among 1000 women after Wenchuan earthquake.All the women were divided into endocrine disorder group(477 women) and normal endocrine group(523 women) according to occurrence of endocrine disorder or not.A self-made questionnaire scale and PTSD symptom checklist were used to investigate general condition and prevalence of PTSD.Peripheral venous blood samples were obtained,ELISA was used to detect the levels of estrogen and progesterone,the correlation between PTSD symptom score and levels of serum hormones was analyzed.Results The incidence rate of endocrine disorder was 47.7%(477 women).The women in endocrine disorder group were older,the incidence rates of staying in buildings,houses collapse,injury,burying,death of family members were higher,the time to obtain a residence was longer after earthquake,the proportion of food and drug shortage was higher,there were statistically significant differences( P<0.05).The incidence rate of PTSD and symptom score in endocrine disorder group were statistically significantly higher than those in normal endocrine group(P<0.05).The levels of serum estradiol(E_2),progestogen(P),and follicle-stimulating hormone(FSH) in endocrine disorder group were statistically significantly lower than those in normal endocrine group(P<0.05).Correlation analysis showed that there were negative linear correlations between PTSD symptom score and levels of serum E_2,P,and FSH(P<0.05).Conclusion Female endocrine disorder after earthquake is likely to be a signal of PTSD,which should be paid more attention to.
引文
[1]Smoller JW.The Genetics of Stress-related disorders:PTSD,depression,and anxiety disorders[J].Neuropsychopharmacology,2016,41(1):297-319.
[2]Morris MC,Compas BE,Garber J.Relations among posttraumatic stress disorder,comorbid major depression,and HPA function:a systematic review and meta-analysis[J].Clin Psychol Rev,2012,32(4):301-315.
[3]袁红,刘惠亮,陈金宏,等.创伤后应激障碍的早期发病机制[J].中华灾害救援医学,2014,2(2):110-112.
[4]Michopoulos V,Norrholm SD,Jovanovic T.Diagnostic biomarkers for posttraumatic stress disorder(PTSD):promising horizons from translational neuroscience research[J].Biol Psychiatry,2015,78(5):344-353.
[5]赵静,江在森,武艳强,等.汶川地震前龙门山断裂带闭锁程度和滑动亏损分布研究[J].地球物理学报,2012,55(9):2963-2972.
[6]徐向东,吕淑云,张莉,等.突发群体事件后社区居民创伤后应激障碍及抑郁症的相关因素[J].中国心理卫生杂志,2014,28(4):241-247.
[7]常保荣,王小梅.运动创伤后应激障碍与神经-内分泌-免疫关系的研究进展[J].职业与健康,2015,31(10):1428-1431.
[8]向莹君,熊国玉,董毅强,等.汶川地震灾区1960名中学生创伤后应激障碍症状调查[J].中国心理卫生杂志,2010,24(1):17-20.
[9]普天磊,薛嫚,沈慈丹,等.血清雌二醇水平分析方法研究进展[J].中华生殖与避孕杂志,2016,36(12):1017-1024.
[10]孙赟,刘平,叶虹,等.黄体支持与孕激素补充共识[J].生殖与避孕,2015,35(1):1-8.
[11]何盛昱,陈进东,马小红,等.严重创伤后女性下丘脑-垂体-卵巢轴的变化研究[J].医药与保健,2013,21(12):54.
[12]Pitman RK,Rasmusson AM,Koenen KC,et al.Biological studies of posttraumatic stress disorder[J].Nat Rev Neurosci,2012,13(11):769-787.
[2]Morris MC,Compas BE,Garber J.Relations among posttraumatic stress disorder,comorbid major depression,and HPA function:a systematic review and meta-analysis[J].Clin Psychol Rev,2012,32(4):301-315.
[3]袁红,刘惠亮,陈金宏,等.创伤后应激障碍的早期发病机制[J].中华灾害救援医学,2014,2(2):110-112.
[4]Michopoulos V,Norrholm SD,Jovanovic T.Diagnostic biomarkers for posttraumatic stress disorder(PTSD):promising horizons from translational neuroscience research[J].Biol Psychiatry,2015,78(5):344-353.
[5]赵静,江在森,武艳强,等.汶川地震前龙门山断裂带闭锁程度和滑动亏损分布研究[J].地球物理学报,2012,55(9):2963-2972.
[6]徐向东,吕淑云,张莉,等.突发群体事件后社区居民创伤后应激障碍及抑郁症的相关因素[J].中国心理卫生杂志,2014,28(4):241-247.
[7]常保荣,王小梅.运动创伤后应激障碍与神经-内分泌-免疫关系的研究进展[J].职业与健康,2015,31(10):1428-1431.
[8]向莹君,熊国玉,董毅强,等.汶川地震灾区1960名中学生创伤后应激障碍症状调查[J].中国心理卫生杂志,2010,24(1):17-20.
[9]普天磊,薛嫚,沈慈丹,等.血清雌二醇水平分析方法研究进展[J].中华生殖与避孕杂志,2016,36(12):1017-1024.
[10]孙赟,刘平,叶虹,等.黄体支持与孕激素补充共识[J].生殖与避孕,2015,35(1):1-8.
[11]何盛昱,陈进东,马小红,等.严重创伤后女性下丘脑-垂体-卵巢轴的变化研究[J].医药与保健,2013,21(12):54.
[12]Pitman RK,Rasmusson AM,Koenen KC,et al.Biological studies of posttraumatic stress disorder[J].Nat Rev Neurosci,2012,13(11):769-787.