口腔肿瘤患者精神心理因素评估及相关物质基础的初步研究

Preliminary study of assessment of mental health level among oral tumor patients and difference of relevant material basis

目的认识口腔肿瘤患者及配偶的精神心理因素变化规律,探索其相关物质基础。方法选取2011年12月—2012年8月间四川大学华西口腔医院确诊的口腔恶性肿瘤患者40例、良性肿瘤患者35例、恶性肿瘤配偶18例,应用症状自评量表(SCL90)按照5级评分标准,测评每位受试者精神心理状况。于入院次日上午9点抽取受试者的全血,分离提取血清,采用高效液相色谱-质谱分析血清中儿茶酚胺以及糖皮质激素含量。结果恶性肿瘤组强迫症状、抑郁与其他因子分均高于良性肿瘤组,差异有统计学意义(P<0.05);恶性肿瘤组强迫症状、偏执与恐怖因子分均高于恶性肿瘤配偶组,差异有统计学意义(P<0.05)。各组间总分及其他单项因子分差异无统计学意义。血清中肾上腺素、去甲肾上腺素、氢化可的松及可的松的检测中,恶性肿瘤组与良性肿瘤组、恶性肿瘤配偶组间差异均有统计学意义(P<0.001)。结论口腔肿瘤患者存在明显的精神心理因素变化,同时伴有机体内相关物质变化,影响着恶性肿瘤的发生发展,对进一步研究恶性肿瘤疾病进程的相关机制及探索干预方法有重要价值。

Objective To investigate the difference in mental health status of oral tumor patients and their spouses, and explore the differences on the basis of relevant materials. Methods Forty patients with oral cancer, eighteen spouses, and thirty- five patients with oral benign tumor were diagnosed in the West China Hospital of Stomatology between December 2011 and August 2012 and assessed with symptom checklist-90 （SCL90） （the 5-grade scoring）. Participants were assessed independently according to their conditions. Blood samples were obtained from the participants by syringe on the second admission day. A method was developed to determine the concentrations of catecholamine and glucocorticoid in the serum using high performance liquid chromatography-tandem mass spectrometry（HPLC-MS/MS）. Results The scores for compel, depression and rests in the cancer group and benign tumor group were statistically significant （P〈0.05）. The scores for compel, dread and stubborn in the cancer group and their spouses were statistically significant （P〈0.05）. The differences between the total and other monomial factor scores were not statistically significant. However, the contents of epinephrine, norepinephrine, cortisone and hydrocortisone in the serum, as determined by HPLC-MS/MS, were significantly different （P〈O.O01）. Conclusion Psychiatric factors do not show a simple factor effect on patients. Symptoms of patients may be based on tumorigenesis and deve- loped in small molecules. Further research is required.