军事演习应激下野战部队军人的心理及和肽素水平的变化

The influence of military exercises on mental health and serum copeptin of the soldiers in field army

目的研究军事演习应激对野战部队官兵心理的影响，探索应激情况下血清和肽素（copeptin）水平的变化。方法军事演习前对294名军人采用军人心理应激自评问卷（Psychological stress self evaluation test，PSET）筛选T〈70得分者于演习前用自编一般情况量表进行测量，演习后用PSET及症状自评量表（Symptom Checklist 90，SCL-90）测量，根据演习后PSET得分，将T≥70得分者确定为高应激组，T〈70为低应激组。于演习前后均抽取静脉血检测血清和肽素、皮质醇和醛固酮水平。结果（1）根据演习前PSET测评筛选出263名T〈70得分者作为最终研究对象，演习后104名（39．5％）军人出现高应激状态，主要表现为焦虑、睡眠及饮食欠佳及敌对；（2）高应激组年龄[（21．51±3．13）分]明显小于低应激组[（24．09±4．16）分，P〈0．01]，曾参加军事演习的比例（37．50％）明显低于低应激组（57．23％；P〈0．01），士兵比例（68．27％）较低应激组高（54．09％；P〈0．01）；（3）高应激组EPQ—N得分[（10．43±1．78）分]明显高于低应激组[（8．77±1．67）分，P〈0．01]；（4）军事演习后263名军人的血清和素肽、皮质醇和醛固酮浓度均明显升高（P〈0．01），且高应激组军人的血清和肽素浓度[（11．36±2．21）pmol/L]明显高于低应激组[（9．43±2．34）pmol／L，P〈0．01]；（8）由多元线性逐步回归分析得到：PSET得分=27．909＋3．669X（X为演习后和肽素水平），演习后和肽素水平≥11．472pmol／L即为高应激心理状态的预警值。结论军事演习应激条件下野战部队军人心理及相关激素均有明显变化，血清和肽素水平可以作为判断应激程度的灵敏指标。

Objective To investigate the characteristics of the mental health and the change of serum copeptin,cortisol and aldosterone levels of the soldiers in field army under military exercises stress. Methods A total of 294 soldiers were evaluated with the psychological stress self evaluation test （PSET） before the exercises and the soldiers whose PSET score were T 〈 70 had to accept the survey with the general information questionnaire before the exercises, and another two questionnaires including PSET and Symptom Checklist 90 （SCL-90） after the exercises, the higher stress group and lower stress group were defined according to the PSET score,T≥70 and T 〈 70 respectively. Meanwhile,we draw the venous blood of them in order to detect the serum concentration of copeptin,cortisol and aldosterone before and after the military exercise. Results （ 1 ） After the survey of PSET before the exercises,263 soldiers were determined to be the final research objects. According to the score of PSET after the exercises, 104 soldiers（ 39.5% ） were considered as the higher stress group, and the symptoms mainly included anxiety,hostility and poor sleep and appetite. （2） Compared with the lower stress group, the higher stress group were younger（21.51 ± 3. 13 vs 24.09 ± 4. 16, P 〈 0.01 ） , higher at the proportion of soldiers （68.27% vs 54.09% , P 〈 0.01 ） and lower at the proportion of soldiers who have experiences of military exercises （37.50% vs 57.23% , P〈0.01 ）. （3） Compared with the lower stress group,the higher stress group had higher score in EPQ- N （ 10. 43 ± 1.78 vs 8.77 ± 1.67, P 〈 0.01 ）. （4） The serum levels of copeptin （ P 〈 0. 01 ） , cortisol （ P 〈 0. 01 ） and aldosterone（ P 〈 0.01 ） have increased after the military exercise. Compared with the lower stress group, the higher stress group have higher serum copeptin level（ 11.36 ± 2.21 vs 9.43 ± 2.34, P〈 0.01 ） after the exercises. （5） The relationship between PSET score and the copeptin level ＇after exercise can be expressed as a formula：PSET score = 27. 909 ＋ 3. 669X （ X ： copeptin level ＇after exercise）, and 11. 472 pruol/L was considered as the threshold value. Conclusion As a strong stress agent, military exercises may cause obvious physiological changes and has notable effect on related hormones. The change of serum copeptin level can be used as a sensitive indicator to determine the degree of stress.