结直肠癌患者术后化疗所致焦虑情绪与内分泌紊乱、免疫应答的相关性研究

Correlation of the anxiety caused by postoperative chemotherapy with endocrine disorder and immune response in patients with colorectal cancer

目的:探讨结直肠癌患者术后化疗所致焦虑情绪与内分泌紊乱、免疫应答的相关性。方法:选取在本院接受结直肠癌根治术及术后化疗的患者110例,根据化疗1疗程后焦虑自评量表(SAS)评分值分为无焦虑组(SAS<50分)29例、轻中度焦虑组(50≤SAS≤69)63例、重度焦虑组(SAS≥70分)18例。对比三组患者化疗前后RAAS指标、单胺类神经递质、Th1/Th2细胞因子、Th17/Treg细胞因子含量的差异。结果:化疗前,三组患者血清中RAAS指标、单胺类神经递质、Th1/Th2细胞因子、Th17/Treg细胞因子含量的差异无统计学意义(P>0.05)。化疗1疗程后,轻中度焦虑组、重度焦虑组患者血清中RAAS指标REN、AngⅡ、ALD的含量高于无焦虑组;单胺类神经递质NE、DA的含量高于无焦虑组;血清中IL-2的含量高于无焦虑组,IL-4的含量低于无焦虑组;血清中IL-17的含量高于无焦虑组,IL-10的含量低于无焦虑组,且重度焦虑组患者血清中上述指标含量改变程度大于轻中度焦虑组(P<0.05)。结论:结直肠癌患者术后化疗所致焦虑情绪可直接导致其内分泌紊乱、细胞免疫功能下降,且随焦虑情绪加重、负面改变加剧。

Objective:To study the correlation of the anxiety caused by postoperative chemotherapy with endocrine disorder and immune response in patients with colorectal cancer.Methods:110patients who received radical operation for colorectal cancer and postoperative chemotherapy in the hospital between August2014and December2016were divided into the non anxiety group(SAS<50points)(n=29),mild to moderate anxiety group(50≤SAS≤69)(n=63)and severe anxiety group(SAS≥70points)(n=18)according to self rating anxiety scale(SAS)score after one course of chemotherapy.The differences in the levels of RAAS indexes,monoamine neurotransmitters,Th1/Th2cytokines and Th17/Treg cytokines were compared among three groups of patients before and after chemotherapy.Results:Before chemotherapy,the differences in serum levels of RAAS indexes,monoamine neurotransmitters,Th1/Th2cytokines and Th17/Treg cytokines were not statistically significant among the three groups of patients(P>0.05).After one course of chemotherapy,serum RAAS indexes REN,AngⅡand ALD levels of mild to moderate anxiety group and severe anxiety group were higher than those of non anxiety group;monoamine neurotransmitters NE and DA levels were higher than those of no anxiety group;serum IL2level was higher than that of non anxiety group while IL4level was lower than that of non anxiety group;serum IL17level was higher than of non anxiety group while IL10was lower than that of non anxiety group;the changes in serum levels of the above indexes of severe anxiety group were greater than those of mild to moderate anxiety group(P<0.05).Conclusion:The anxiety caused by postoperative chemotherapy in patients with colorectal cancer can directly lead to the endocrine disorder and the decrease of cellular immune function,and the negative changes increase with the aggravation of anxiety.