初次与重复接受体外受精胚胎移植治疗患者心理应激的对比研究

A Comparative Study of Psychological Stress in Veterans and Inductees Women Undergoing IVF-ET Treatment

目的探讨初次接受IVF治疗的患者与重复接受治疗者之心理应激诸方面(压力感知、情绪、应对方式)的差异。方法以接受IVF治疗的患者为被试,分别于周期第2日、取卵前当日晨、移植前当日晨和孕检前4个时点进行应激感受性量表(PSS)、状态-特质焦虑问卷(S-TAI)、抑郁自评量表(SDS)和医学应对问卷(MCMQ)测量。按患者接受IVF治疗的次数,将324例患者分为初次治疗组(n=258)及重复治疗组(治疗次数≥2,n=66),对比两组患者的压力感知、情绪状况和应对方式。结果初次治疗组PSS分数显著低于重复治疗组[(24.88±4.961)∶(26.73±4.626),P<0.01],但与常模无显著性差异,重复治疗组分数显著高于常模(P<0.01)。初次治疗组TAI分数显著低于重复治疗组[(40.59±8.538)∶(42.98±8.148),P<0.05]。两组TAI得分与常模分值相比均无显著性差异。初次治疗组周期第2日SAI分值显著低于重复治疗组[(38.67±8.943)∶(41.97±8.690),P<0.05],但与常模无显著性差异,重复治疗组周期第2日SAI分值显著高于常模(P=0.01)。初次治疗组周期第2日SDS分值显著低于重复治疗组[(43.59±9.581)∶(47.65±10.105),P<0.01]。两组患者周期第2日SDS分值均显著高于常模(P<0.01)。不同时点之SAI及SDS分值差异均有统计学意义(P<0.01),且测量时点与周期数分组间不存在交互作用,不同治疗周期组间的SAI及SDS分值差异均有显著性(P<0.01)。结论重复接受IVF治疗的患者,其周期第2日的压力感知性、焦虑水平和抑郁水平均高于初次治疗者。IVF治疗过程中,重复组的状态焦虑及抑郁水平高于初次治疗组,且两组的状态焦虑和抑郁程度均呈上升趋势。

Objective To investigate the differences in psychological stress among veterans and inductees women undergoing IVF - ET treatment. Methods A total of 258 first time and 66 repeat cycle patients who had undergone IVF treatment completed PSS, STAI, SDS and MCMQ questionnaires at four time points to evaluate stress status and change of patients in two groups. Results PSS score of inductees was significantly lower than that of repeat cycle group （24.88 ±4. 961 vs 26.73 ±4. 626,P 〈0. 01 ）. TAI score of the first cycle group was significantly lower than that of repeat cycle group （40.59 ± 8. 538 vs 42.98 ± 8. 148, P 〈0.05）. There was no significant difference in TAr score and norm score between two groups. The baseline SAI and SDS score of inductees were significantly lower than veterans （P 〈0.01 ）. The MCMQ score of two groups was not significantly different, There was significant difference in the SAI and SDS score with different time points （P 〈0. 01 ） , and also there was significant difference in the SAI and SDS score with IVF treatment cycles （ P 〈 0.01 ）. Conclusion The baseline perception of the pressure, the level of anxiety and depression of veterans were higher than those of the first cycle patients. In the course of IVF treatment, the repeating group showed higher level of state anxiety and depression than the inductees, but state anxiety and depression levels of the both groups showed an upward trend over time.