维普资讯 http://www.cqvip.com 第29卷3期 2007年6月 宁夏医学院学报 Journal of Ningxia Medical c ̄k3go ・273・ 文章编号i1005—8486(2007)03—0273—02 ・论著・ 习惯性流产患者的心理因素分析 钟慧军, 霍正浩, 焦海燕, 党 洁, 陆宏, 朱永生, 彭 亮, 陈银涛 750(104) (宁夏医学院医学遗传及细胞生物学教研室,银川摘要:目的探讨心理因素对习惯性流产的影响。方i支对62例习惯性流产妇女进行9o项症状自评量表、 艾森克人格问卷、焦虑自量表、抑郁自量表的调查,并做统计学分析。结幂 习惯性流产妇女有较高的焦虑、 抑郁和躯体症状,与情绪等有一定的相关性。结论关键词:习惯性流产;心理因素;问卷调查 中图分类号:R493 文献标识码:A 表1 scL一90测评心身症状因子分与女性常模比较 对习惯性流产患者应制定相应的心理干预策略。 习惯性流产又称复发性自然流产(ret ̄mt spontaneous abortion,RsA),指妊娠在孕28周前自然终止,反复3次以 上,是生育期常见的疾病。其发病原因复杂,包括遗传缺 陷、激素或内分泌异常、子宫畸形、感染、血栓形成倾向环境 和个人行为因素等原因外,30%一40%原因不明…。目前, 精神心理因素对习惯性流产影响研究甚少,本文旨在探讨 精神心理因素与习惯性流产的相关性。 1对象与方法 1.1研究对象2003年3月一2006年3月,就诊于本室遗 传咨询门诊的习惯性流产患者62例,连续流产3—6次,无 活产史,年龄21 36岁。受教育程度为小学以上文化,能 完成相应调查表格的理解和填写;同时,排除其遗传缺 2.2心身症状水平的影响因素分析 习惯性流产组 SCL一9o各因子分与Ⅱ 各维度分的相关系数(r)显示患 陷、激素或内分泌异常、子宫畸形、感染、血栓形成倾向所引 起的习惯性流产。 者身心症状与神经质有显著相关性,见表2。 表2心身健康与心理社会应激因素的相关系数 1.2研究方法采用一对一的问卷调查方法,使用调查表 及量表如下:1)一般项目:调查并记录被调查者年龄、学历、 职业。2)90项症状自评量表(S 一90) r J,记录9个因子分 及总均分,条目以1—5级计分。3)艾森克人格问卷EPQ (成人)[33,陈仲庚修订,记录精神质(P)、神经质(N)、外向 (E)和掩饰(L)等4项个性特征量分,条目以1—4级计分。 4)焦虑自量表(sAS,20题)_3 J,条目以1—4级计分。5)抑郁 自量表(SDS,20题)_3 J,条目以1—4级计分。 1.3统计学方法2结果与分析 问卷调查资料统一用SPSS 11.0统计软 *显著正相关 件完成,进行t检验和相关性分析。 2.1 SCL一90测评结果SCL一90测评结果与女性常模比 2.3焦虑自量表、抑郁白量表评定结果 焦虑自量表总粗分(38.51±8.99)分,标准总分 较,躯体化、强迫症状、人际关系、敏感、抑郁、焦虑、敌对、恐 (48.14±11.24)分;常模【2 总粗分(29.78±10.07)分,标准总 怖、偏执精神病症等因子得分均显著高于国内女性常模_2 J, 分(37.23±12.59)分,总分差异显著(t=6.71,P<0.01)。 两组差异有统计学意义(P<0.01),见表1。 抑郁自量表总粗分(42.13±8.10)分,标准总分 (52.67±10.13)分;常模[2 总粗分(33.46±8.55)分,标准总 收稿日期:2006—08—31 分(41.88±10.57)分,总分差异显著(t=7.88,P<0.01)。 3讨论 基金项目:宁夏医学院基金资助 作者简介:钟慧军(1966一),女,副教授,学士,从事医学遗传学研究 及相关遗传咨询工作。 习惯性流产的病因比较复杂、发病率较高,已成为近年 来生殖健康所关注的热点问题。习惯性流产除与染色体异 维普资讯 http://www.cqvip.com ・274・ 宁夏医学院学报 29卷 常、黄体功能不全、免疫、解剖等因素有关外,仍有30%多 惯性流产史即将生育家庭进行心理健康教育,通过提供心 的习惯性流产无法查明原因。有研究发现72%的习惯性 理支持和帮助,缓解她们焦虑、抑郁、敏感症状,使身心得以 流产者对工作学习、娱乐等失去兴趣 J,往日的不幸使他们 充分休息,达到治疗的效果。 变得小心翼翼,高度敏感,对流产原因的错误理解,使之焦 虑、恐惧、怀疑、封闭,而过度的焦虑、恐惧使交感神经兴奋, 参考文献: 子宫对交感神经的兴奋也增加,从而导致流产的再次发 [1]ACOG Committee oH Practice Bulletins.ACOG Practice bu1. 生_5 J。本调查结果显示,习惯性流产患者其躯体化、强迫症 1efins.Management of recurrent Pregnancy loss Number 24, 状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病症 February 2001(Replaces Technical Bulletin Number 212, 等因子得分均高于国内女性常模。焦虑自量表、抑郁自量 September 1995),American College of Obstetricians and 表评定结果再次说明习惯性流产患者抑郁、焦虑程度比正 Gynecologists[J].Int J Gynaecol Obstet,2OO2,78:179— 常人要高,尤其是抑郁程度较高,与SCL一90测评结果一 190. 致。说明习惯性流产女性的心理健康水平显著低于正常女 [2]金华,吴文源,张明园.中国正常人SCL一90评定结 性,她们精神紧张抑郁程度高,人际关系敏感,消极敌对情 果的初步分析[J].中国神经精神疾病杂志,1986,12: 绪严重,对再次妊娠产生恐惧,流产次数越多,心理健康水 260—263. 平越差。 [3]吴均林,林大熙,姜乾金.医学心理学教程[M].北 在相关性方面,本组习惯性流产患者心身症状各因子 京:高等教育出版社,2003.113—115,119—120. 分在心身症状方面与个性外向(E)成负相关,而与个性的 [4]周晓星,孙晓霞,孟茜.人工受精后早孕妇女的心理 精神质(P)、情绪不稳(N)和掩饰(L)成正相关。显示那些 调查分析[J].护理学杂志,2004,19(7):02—21. 有较高的情绪不稳定、内向和精神质等个性特征的患者,习 [5]张志诚.临床产科学[M].天津:天津科学技术出版 惯性流产对她们的心身健康影响较大。 社,2O04.727. 精神心理因素对习惯性流产的影响必须引起临床医生 (责任编辑:任义芳) 的注意。对习惯性流产妇女在躯体治疗的同时,应对有习 (下转第277页) (上接第268页) [6] 丁国芳,张苏平,姚丹,等.我国部分地区正常新生儿 测定、脑干诱发电位对诊断胆红素脑病的价值[J].实 黄疸的流行病学调查[J].中华儿科杂志,20O0,38 用儿科临床杂志,2002,17(3):211. (10):624—627. (责任编辑:路锦绣) [7]刘华君,纳志云,魏群德,等.新生儿20项行为神经 The Clinical Significance of Hearing Screeing on the Brnirtstem Auditory Evoked Potential in Neonatal with Jaundice SUN Hai-feng,LIU Nan-ping,ZHOU Li-ming,SHA Yan。ni (EEG Room,Hospital of Ningxia Medical College,Yinchuan 750004) Abstract:Objective To explore the value of early diagnosis and clinic signiifcance of following・up on the brainstem auditory evoked potentila(BAEP)in neonates wiht iaundiec.Methods B was detected in 258 neonates wiht iaundiec by the myoelectricity evoked optentila machine(DANTEC,Denmark).6o cases neonatal patients wiht hearing lOSS r birth of 3 month and 6 month underwent BA口test respectively.Results rhe abnormality rate of BAEP in 258 cases WaS 81.01%.111e abnormal findings in BAEP included prolongation of PL and I】PlL of hte wave I、llI and V,and undiferentiation or disappearance of hte waveshape.60 infants who had abnormal B s received following.up B test.Average hear threshold of the neonates after birth of 3 month and 6 month were(70±14.6)danHL and(42±12.6)dBnHL respectively(P<0.001).Conclusion ]f11e jaundice can cause damage to peripheral auditory nerve and brainstem function of the neonate.There are di— rectly relations between iaundice degree and abnormal degree of BA ,prognosis.It iS economically practicable that the technique of BAEP WaS used to examine the neonatal patients with hearing lOSS after birth of six-month nad early intervention was performed in patients witI1 hearing loss. Key words:bilirubinemia;brainstem auditory evoked potentila;neonate;jaundice;hearing examine 维普资讯 http://www.cqvip.com 3期 参考文献: 李国莉,等.枸杞对酒精性肝损伤大鼠保护作用的实验研究 ・277・ [5]陈倏莺,胡天喜.中药复方和某种植物分泌激素对脂 质过氧化的抑制作用[J].发光学报,1994,15(4): 348—350. [1]罗琼,阎俊.枸杞及其多糖对家兔血脂的影响[J].营 养学报,1997,19(4):415—418. 宋广杰,侯丽娟,等.护肝饮对大鼠酒精性肝损 [2]李舒丹,厉有名,虞朝辉.大鼠慢性酒精性肝损伤模 [6]田时,型的建立[J].浙江医学:2002,24(9):524—530. [3]朴丽花,金政,李相伍.悦肝胶囊对小鼠酒精性肝损 22—25. 伤的保护作用研究[J].中医药学刊,2004,22(1): 180一l82. 伤的保护作用[J].延边大学医学学报,20O4,27(1): [7]李国莉.宁夏枸杞不同组分黄酮含量分析[J].宁夏 医学院学报,1995,17(2):114—115. [4]杨成峰,陈学敏,刘军,等.酒精对大鼠肝脏脂质过氧 (责任编辑:路锦绣) 化的影响[J].现代预防医学,1996,23(3):BI41—143. The Study of Protection Function of Lycium Barbarrmn on Alcoholic Liver Injury in Rats L/Guo-li,YANG Jian-jun,ZHAO Wei-ming,et al (The School of Public Health,Ningxia Medical College,Yinchuan 750004) Abstract:Objective To explore he prtotection effects of Lycium barbamlm(LB)on alcoholic liver injury in rats.Methods Sixty male rats weighed 300—340g were randomly divided into four groups.The blank group were given distilld ewater and basic animal feeds.The other three groups were given 56 degrees spirit by 10ml/ kg・bw.The alcohol model rats were fed with basic animal feeds.The low dose group rats were fed with basic animal feeds and LB 50g/kg.The hih gdose group atrs were fd eitwh basic animal feeds and LB 100g/kg.After three weeks.we took serum from heart and liver organization to detect the ALT,SOD,CAT,MDA,T-AOC nd cheack the pathological slice of liver organization.Results Compared with the alcohol model group,LB group’s activity of SOD.CAT were signiifcantly higher.The activiyt of serunl ALT in LB group were signm— cantly lower than hatt in the aloholc model group(P<0.01).The concentration of MDA in the aloholc model group were signiifcantly lower than that n ihe atloholc model group(P<0.05). e pathological esrulst showed hatt LB had certain protection effcte on aloholc liver injury in atrs.Conclusion LB has lipid per-oxidation and protection effctes for atrs with alcohol fiver injury. Key words:Lycium barbarmm;rats with aloholcic fiver bury;lipid erp-oxiatdion (上接第274页) Psychosomatic Symptoms of Patients witll Habitual Abortion ZHONG Hui-jun,HUO -hao,JIAO hai—yan,et al (Department of Medical Genetics and Cell Biology,Ningxia Medical College,Yinchuan 750004) Abstract:Objective To explore the psychosomatic symptoms of the women with habitual abortion.Meth- ods A total of 62 women diagnosed as habitual abortion were administered with symptom Checklist 90(SCL- 90),Eysenck Personality Quesitonnaire,SAS and SDS.Results The women with habitual abortion scored ighlhy on anxiety,depression and somatic smptyoms,which was not related with occupation and age,but it has elration with emotion.Conclusion In the treatment nd healah carte of patients with habitual abortion,specila psychological intervention strategy should be made out based on the psychosomatic features of this population. Key words-habitual abortion;psychosomatic smptyoms;psychosocil factaors