弥漫性甲状腺肿伴甲状腺机能亢进症病人的心理应激因素分析

The analysis of psychological stress factors in the patients with graves disease

目的 通过弥漫性甲状腺肿伴甲状腺机能亢进症 (又称Graves病 )临床对照研究 ,探讨Graves病病因、病程中的应激因素。方法 本研究采用定式问卷评定研究对象 :病例组 ( 61例 )、疾病对照组 ( 3 0例 )、健康对照组 ( 3 0例 )的一般情况 (包括吸烟、饮酒、家庭关系等 ) ,生活事件量表 (LES ,生活事件限于病前 1 2个月内 ) ,社会支持评定量表 (SSRS) (限于病前 1 2个月内 )。结果 一般情况的研究 :疾病组吸烟行为明显多于两个对照组 ,两对照组之间无差异 ,在饮酒行为中 ,肝炎组病人最高 ,其次是疾病组 ,最少是正常组。与两个对照组相比 ,疾病组病人家庭关系较多的不和谐 ,两个对照组之间没有明显差异。生活事件的研究 :病人病前 1 2个月内经历的负性生活事件数和生活事件总数均高于二个对照组 ,负性刺激量和总刺激量显著高于两个对照组 ,说明Graves病人病前承受心理负荷较高。社会支持的研究 :与正常组和疾病对照组相比 ,Graves病人组社会支持量表总分、主观支持分、支持利用度明显低 ,正常组与疾病对照组社会支持量表分没有显著性差异。结论 负性生活事件发生在Graves病的发生中起重要作用。缺乏社会支持、家庭关系不和谐、不良的行为方式、是导致Graves病发生的重要因素。

Objective This investigation was to understand the psychological stress factors in the etiology and course of graves disease by using clinical controlled study.Methods The study included three groups,the case group(n=61),the disease controlled group(n=30) and normal controlled group(30).The general condition(including smoking,drinking alcohol,family relation,etc),life events and social support for all subjects were assessed.Results Comparing with two controlled groups,the smoking behavior in case group was more than that of the controlled groups(P<0.05)and no significant differences was found in the two controlled groups(P>.0.05);drinking alcohol behavior in case group was more than that of normal controlled group,but less than that of the disease controlled group(P<0.05);The poor life events and family relation in case group were more than that of the two controlled groups(P<0.05).Conclusion The negative life events play important role in the etiology and course of graves disease,such as lack of social support,poor family relation and abnormal behavior pattern.