支气管哮喘患儿的神经应激反应与气质的相关性研究

Correlation of the stress reaction and temperament in children with bronchial asthma

摘要:

目的：探讨支气管哮喘患儿神经应激反应与气质的相关性。方法：选择2008年2月至2010年5月3~7岁支气管哮喘患儿220例作为研究对象，同期年龄、性别匹配的无哮喘、无呼吸道感染、无严重躯体疾病和精神障碍的儿童80例作为对照组。由两组父母填写3~7岁Carry气质量表；免疫化学发光法检测两组血清皮质醇(8am和4pm)和神经生长因子（NGF）水平。结果：哮喘组在气质维度中的节律性、持久性低于对照组，而在趋避性、反应强度、情绪本质、适应性、注意分散等方面得分较对照组高，差异有统计学意义(P<0.05)。哮喘患儿8am和4pm的皮质醇水平均较对照组低，NGF水平则明显高于对照组，差异有统计学意义（P<0.05）。哮喘患儿的气质维度在反应强度、情绪本质、适应性方面与NGF水平呈正相关（r=0.348，0.468，0.195），而与8am的皮质醇水平呈负相关（r=-0.297, -0.462, -0.152）。结论：哮喘患儿的气质维度与神经应激反应相关，为下一步通过神经心理调节来干预支气管哮喘的治疗提供了理论依据。

Abstract:

OBJECTIVE: To study the correlation between the temperament dimension and the stress reaction in children with bronchial asthma. METHODS: Between February 2008 and May 2010, two hundred and twenty children with bronchial asthma and aged from 3-7 years were enrolled (asthma group). Eighty children without asthma, respiratory tract infections, serious body diseases and mental disorders who were age- and gender-matched to the asthma group served as the control group. The Carry temperament rating scales were filled by the children′s parents from the asthma and control groups. The serum levels of cortisol at 8am and 4pm and nerve growth factor (NGF) were measured by immunochemiluminescent assays. RESULTS: The scores of the rhythmicity and persistence in temperament dimensions in the asthma group were significantly lower than those in the control group; in contrast, the scores of phobotaxis, response intensity, emotion entity, adaptability and attention dispersion in the asthma group were significantly higher than those in the control group (P<0.05). The levels of serum cortisol at 8am and 4pm were lower, while the serum level of NGF was higher in the asthma group than those in the control group (P<0.05). The scores of response intensity, emotion entity and adaptability in temperament dimensions were positively correlated with serum NGF level (r=0.348, 0.468, 0.195, respectively; P<0.05), and inversely correlated with serum cortisol level at 8 am (r=-0.297, -0.462, -0.152, respectively; P<0.05) in the asthma group. CONCLUSIONS: The temperament dimension is associated with the stress reaction in children with bronchial asthma. This provides a basis for the treatment of bronchial asthma by neuropsychological adjustment.