肠易激综合征患者个性、社会心理因素对照研究

目的 探讨肠易激综合征患者个性特点及社会心理因素对发病的影响。方法 采用艾森克个性问卷（EPQ）、生活事件量表（LES）、症状自评量表（SCL－90）对肠易激综合征病人和正常人进行评定。结果 肠易激综合征病人的EPQ中E分明显低于正常对照组（P＜0．01）,N分明显较对照组高（P＜0．01）;负性生活事件的频度及其刺激量明显高于对照组（P＜0．01）,生活事件总刺激量较对照组高（P＜0．05）;SCL－90评定显示肠易激综合征病人在躯体化、抑郁、焦虑、敌对性、恐怖、精神症诸因子及阳性项目数与正常对照组存在差异（P＜0．01－0．05）。结论 肠易激综合征病人在个性方面存在差异,社会心理因素对发病有影响。     

中小学教师焦虑症状及相关因素的研究

目的 探讨中小学教师焦虑症状的发生情况及相关因素。方法 采用SAS、SCL—90、LES、EPQ四种量表对520名中小学教师进行测试。结果 520名中小学教师SAS均分为3216±8. 20分,SAS>50分者占5.19％,常见的焦虑症状为乏力、焦虑心境、睡眠障碍、静坐不能、多汗、惊恐、恶梦等。SAS与SCL—90的各因子分呈显著正相关,与EPQ的N量表呈显著正相关,与LES的生活事件总值、负性生活事件值是显著正相关。结论 中小学教师焦虑症状的发生不是孤立单一因素作用的结果,与其心理健康水平、遭遇生活事件及个性特征密切相关。提示,在中小学教师中开展心理卫生工作有着重要的现实意义。     

神经衰弱患者EB病毒的免疫检查所见

目的　了解神经衰弱与EB病毒 (EBV)的关系。方法　对 34例符合中国精神疾病分类方案与诊断标准第 2版修订本中神经衰弱诊断标准的患者 (病例组 )和 33名年龄、性别及文化程度与病例组基本匹配的健康者 (对照组 ) ,用酶联免疫吸附方法检测血清EB病毒抗体IgG和IgM ,并用聚合酶链反应技术检测外周血EB病毒基因 (EBVDNA)表达。病例组经 4个月的常规药物治疗和心理治疗后重测上述指标。结果　病例组的EBVIgG(76 %)、IgM(2 4%)阳性率均高于正常对照组 (分别为5 2 %和 0 ) ,差异有显著性 (P =0 0 33,0 0 0 3) ;EBVIgG效价 (1 15± 0 2 6 )及外周血EBV基因表达阳性率(6 %)也高于对照组 (分别为 1 0 9± 0 2 8和 0 ) ,但差异无显著性 (P =0 5 6 3,0 15 7)。治疗后病例组的症状明显改善 ,其EBVIgG、IgM及EBVDNA阳性率亦有不同程度的下降 (EBVIgG由 78%降至 71%,EBVIgM由 14%降至 11%,EBVDNA由 4%降至 0 ) ,但差异无显著性。结论　神经衰弱患者EBVIgG、IgM阳性率均高于正常对照组 ,且与其临床症状呈同步同向变化。     

抑郁症与心境恶劣障碍患者的甲状腺素水平

目的:测定抑郁症与心境恶劣障碍患者的甲状腺素水平,探讨其神经内分泌改变。方法:对抑郁症30例和心境恶劣障碍30例进行汉密尔顿抑郁量表(HAMD),艾森克人格问卷(EPQ)及生活事件量表(LES)评定。测血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)及促甲状腺素(TSH)浓度。结果:两组间在HAMD总分及T4水平差异显著。抑郁症组T3与EPQ的内外向分及HAMD的迟缓因子分呈正相关;T4与HAMD总分、焦虑因子分及负性生活事件刺激量呈正相关;TSH与正性生活事件刺激量呈正相关。心境恶劣障碍组T3与认知障碍因子分呈负相关;T4与HAMD总分、负性生活事件及迟缓因子分呈正相关。结论:负性生活事件促进了抑郁发作,T4水平可预测抑郁症状的严重程度。     

乳腺癌患者社会心理特征的研究

目的　研究乳腺癌患者的社会心理特点和心身健康状况。方法　运用临床心理评定量表 (LES、EPQ、CS、SSQ、SCL 90 )评定 40例乳腺癌患者遭遇的生活事件、人格特征、应付方式、社会支持、心身健康状况 ,与 40例健康者相比较。结果　乳腺癌患者组病前经历的生活事件总频数及应激强度、负性生活事件频数及应激强度、神经质分、消极应付方式评分显著较多 ,社会支持总分、客观支持分、主观支持分、支持利用度显著较低 ,SCL 90除敌对、恐怖因子外其他因子分增高均具有显著性。结论　乳腺癌患者的社会心理因素有自身的特点 ,应采取积极的社会心理干预措施。     

间接免疫荧光法研究EB病毒感染类型与多发性硬化发生的关系

目的 用间接免疫荧光法研究EB病毒(EBV)不同感染类型与多发性硬化(MS)发生的关系.方法 采用间接免疫荧光法检测20例MS患者和20例其他神经科疾病(OND)患者脑脊液(CSF)中抗EBV壳抗原(EBV-CA)IgG抗体、抗EBV-CA IgG抗体亲和力、抗EBV-CA IgM抗体、抗EBV早期抗原(EBV-EA)...     

多发性硬化患者抗EB病毒抗体阳性检出率的Meta分析

目的 通过Meta分析探讨多发性硬化(MS)患者体内抗EB病毒(EBV)抗体阳性率。方法 检索对MS病例与对照血清中抗EBV抗体进行检测的随机对照试验(RCT),并通过Meta分析探索各种抗EBV抗体与MS之间的关系。计算机检索中国期刊全文数据库(CNKI)、万方科技期刊全文数据库、PubMed、EMbase和维普中文科技期刊全文数据库(VIP),检索时限均从建库至2021年12月。两名研究者严格根据制定的纳入及排除标准独立进行文献筛选并提取基本资料,依据修改后的纽卡斯尔-渥太华量表(NOS)工具评价文献质量。采用Rev Man 5.3软件合并计算所有纳入文献中的每一种抗EBV抗体血清阳性率的OR,并进行敏感性分析和亚组分析。以Egger检验评价发表偏倚。结果 共纳入35项研究。MS患者EBV衣壳抗原抗体(EBV-VCA)IgG/IgM、EBV核心抗原抗体(EBNA)IgG血清阳性率明显高于对照者,效应量指标总体OR值及其95%CI分别为：EBV-VCA IgM(OR=3.44,95%CI:1.93～6.13)、EBV-VCA IgG(OR=4.79,95%CI:2.82～8.15)、...     

煤矿工人工伤事故与心理健康因素的研究

目的探讨煤矿工人工伤事故与个性、心理健康因素、嗜好、工龄、文化程度等因素的关系。方法将出现工伤事故的100人作为研究组，随机匹配未出现工伤事故的100人为对照组，应用自编工伤事故调查表，运用t检验、Х^2检验、单因素分析和多因素非条件Logistic回归分析，对EPQ、SAS、SDS、SCL-90和LES的评定结果进行比较。结果研究组平均年龄、工龄、受教育年限明显低于对照组，家庭经济状况差率、家庭和睦程度差率、未婚率和离婚率、嗜酒率和嗜烟率，明显高于对照组，有显著性差异（P〈0．05）；研究组的LES总分、负性生活事件值和正性生活事件值、SAS分、SDS分、EPQ的E维分和N维分、SCL-90的总均分、各因子分及阳性项目数明显高于对照组，经t检验，有显著性或极显著性差异（P〈0．05或0．01）；单因素和多因素非条件Logistic回归分析：年龄、工龄、受教育年限、烟嗜好、酒嗜好、EPQ的E维分和N维分、SAS、SDS、LES的总分、负性生活事件、SCL-90的总均分、阳性项目数、抑郁因子为有统计学意义的变量。结论工龄低、受教育年限短、酒嗜好、EPQ的E维分和N维分高、负性生活事件、SCL-90的抑郁因子、SDS是井下矿工出现工伤事故的高危因素。     

临床医学生睡眠质量及其影响因素的分析

目的　探讨临床医学生睡眠质量现状及其与心理健康状况、生活事件、应对方式和个性等因素的相互关系。方法　采用匹兹堡睡眠质量指数 (PSQI)、症状自评量表 (SCL 90 )、青少年生活事件量表、应对方式问卷及艾森克个性问卷 ,对中山大学 4 5 0名一、三、五年级的临床医学生进行测查。结果　睡眠问题检出率 17 8% ,三年级睡眠质量较差 ,生活事件应激值、应对方式 ,N、E量表分、SCL 90总均分与睡眠质量呈显著相关 ,各因子间也存在一些显著性相关 ,多元回归分析提示 :学习压力、N分、SCL 90总均分和积极应对分对睡眠质量有显著预测作用。结论　就临床医学生睡眠质量而言 ,生活事件、个性、心理健康状况和应对方式对其既有直接影响又存在交互作用。     

心理社会因素对功能性消化不良的影响

目的：探讨功能性消化不良患者个性心理特征、情感表达能力、生活事件及心理健康水平。方法：采用艾森克个性问卷(EPQ)、多伦多述情障碍量表、生活事件量表(LES)、90项症状清单(SCL-90)对56例功能性消化不良患者进行对照研究。结果：功能性消化不良患者个性内倾，情绪不稳定，神经质明显，掩饰性高，存在述情障碍。病前1年内接受负性生活事件频度和生活事件总值均较对照组高。心理健康水平较对照组低。结论：个性心理特征、情感表达能力、病前生活事件与功能性消化不良发病相关，患者普遍存在抑郁情绪和疑病倾向。     

Acute fatal necrotizing hemorrhagic encephalitis caused by Epstein-Barr virus in a young adult immunocompetent man

Epstein-Barr Virus (EBV) encephalitis is a rare (<1%) and generally self-limited disease with few sequelae. This neurological complication has been reported almost exclusively in the course of acute primary infection and in paediatric patients. We describe a case of a young adult immunocompetent man who developed an acute fatal necrotizing haemorrhagic encephalitis as the only manifestation of an acute EBV infection. EBV-DNA was tested positive in several CSF samples by qualitative and quantitative PCR. Serological profile showed: absence of IgM against Viral Capsid Antigen (VCA) in three different consecutive samples, presence of IgG against VCA and IgG seroconversion for Epstein Barr Nuclear Antigen (EBNA). EBV-DNA was detected by qualitative PCR in autoptic brain material. Clinical course was not influenced by antiviral therapy with acyclovir. In conclusion to our knowledge, this is the only case of acute necrotizing haemorrhagic EBV encephalitis with a fatal outcome, in an adult immunocompetent man.     

急性心肌梗死患者与正常人社会心理因素、个性特征和生活方式的对照研究

目的 探寻社会心理因素、个性特征、生活方式与急性心肌梗死(Acute Myocardial Infarc-tion AMI)的病因学联系。方法 对51例AMI病人和50例正常人应用生活事件量表(LES)、社会支持评定量表(SSRS)、艾森克个性问卷(EPQ)、生活方式定式调查表及一般情况调查表进行对照调查。结果 AMI病人发作前有明显心理刺激因素占80.39％,AMI组负性生活事件发生率更高(P<0.01),社会支持度更低(P<0.01),有更多的外倾行为和情绪不稳定性格,E.N分更高(P<0.01),在生活方式方面AMI组有更多的饮食偏咸,不饮牛奶,喜食肥肉、猪油、高脂食品,业余生活单调,缺乏锻炼,嗜烟酒,睡眠差或睡眠无规律等(P<0.01)。结论 负性事件多发,缺乏亲人和社会支持,不良个性和不良生活方式等均是AMI的发病危险因素。     

Epstein–Barr virus neutralizing and early antigen antibodies in multiple sclerosis

Background: Our objective was to determine whether antibodies against the Epstein–Barr virus (EBV) nuclear antigen‐1 (EBNA‐1), early antigen (EA), and EBV neutralizing antibodies (NeutAb) are altered in multiple sclerosis (MS). Methods: We measured EBNA‐1 IgG, EA IgG, and EA IgA using quantitative ELISA. We measured NeutAb using a quantitative competitive ELISA. We studied 80 patients with MS, 80 matched controls, and 19 patients with MS with samples collected both whilst stable and in relapse. Results: Epstein–Barr virus nuclear antigen‐1 IgG and EA IgA were increased in MS compared to controls. The EBNA‐1 index value was 23.3 ± 18.3 in the patients with MS (mean ± SD) and 16.3 ± 17.4 in the controls (P = 0.007, paired t‐test). EA IgA had a median value of 1.964 in the patients with MS and 1.248 in the controls (P = 0.029, Wilcoxon signed rank test). EA IgG and NeutAb were not significantly different. None of the antibody levels were altered in relapse. The correlation between concentrations of different antibodies was minimal. Conclusions: IgG antibodies to EBNA‐1 are significantly increased in MS. IgA antibodies against EBV EA are also increased. The EBV neutralizing antibody response is similar in MS and controls.     

围绝经期妇女罹患抑郁症的危险因素分析

目的:探讨围绝经期妇女抑郁症的危险因素。方法:80例确诊为抑郁症的围绝经期女性患者(抑郁症组)和120例非抑郁症的围绝经期女性患者(对照组)进行艾森克人格量表(EPQ)、生活事件量表(LES)、社会支持量表(SSRS)的自评,同时检测两组血雌二醇激素(E2)及促卵泡刺激素(FSH)水平并进行比较。结果:抑郁症组血E2水平(t=-8.17,P=0.000)及SSRS主观支持得分(t=-3.44,P=0.001)低于对照组;血FSH水平(t=13.45,P=0.000)、LES总事件刺激分(t=5.42,P=0.00)、负性事件刺激分(t=7.97,P=0.000)、EPQ-N(神经质)分(t=8.32,P=0.000)、EPQ-P(精神质)分(t=3.84,P=0.00)高于对照组。多因素非条件Logistic回归提示,血E2、FSH水平、LES负性事件评分、EPQ-N评分的回归系数β分别为-0.117、1.116、0.372、0.290(P0.01或P0.001)。结论:血E2、FSH水平、社会心理因素、负性事件刺激及神经质人格是围绝经期妇女罹患抑郁症的危险因素。     

Guillain-Barré syndrome and hemophagocytic lymphohistiocytosis in a patient with severe chronic active Epstein–Barr virus infection syndrome

Epstein–Barr virus (EBV) infection causes a wide range of neurologic and hematologic manifestations. We report a 72-year-old Japanese male patient with severe chronic active EBV infection syndrome (SCAEBV) who presented with Guillain-Barré syndrome (GBS) and developed hemophagocytic lymphohistiocytosis (HLH) several months after the onset of GBS. He showed acute onset of distal muscle weakness, ophthalmoplegia and bulbar palsy. Results of nerve conduction study revealed acute motor-sensory axonal neuropathy (AMSAN). His serum was positive for anti-LM1 IgG and anti-GM1b IgM. Titers of antibodies to EBV-related antigens indicated chronic reactivated EBV infection. Treatment with IVIg resolved the acute ophthalmoplegia, but there was no notable improvement in the AMSAN and bulbar palsy despite repeated. Finally, he developed refractory HLH resulting in a fatal outcome. In the present patient, it seems that SCAEBV was associated with the development of GBS and fatal HLH via parainfectious autoimmunity and direct infectious immune mechanisms, respectively.     

Risk of a first clinical diagnosis of central nervous system demyelination in relation to human herpesviruses in the context of Epstein–Barr virus

Background and purpose

Epstein–Barr virus (EBV) is implicated in multiple sclerosis (MS) risk; evidence for other herpesviruses is inconsistent. Here, we test blood markers of infection with human herpesvirus 6 (HHV-6), varicella zoster virus (VZV), and cytomegalovirus (CMV) as risk factors for a first clinical diagnosis of central nervous system demyelination (FCD) in the context of markers of EBV infection.

Methods

In the Ausimmune case–control study, cases had an FCD, and population controls were matched on age, sex, and study region. We quantified HHV-6- and VZV-DNA load in whole blood and HHV-6, VZV, and CMV antibodies in serum. Conditional logistic regression tested associations with FCD risk, adjusting for Epstein–Barr nuclear antigen (EBNA) IgG, EBV-DNA load, and other covariates.

Results

In 204 FCD cases and 215 matched controls, only HHV-6-DNA load (positive vs. negative) was associated with FCD risk (adjusted odds ratio = 2.20, 95% confidence interval = 1.08–4.46, p = 0.03). Only EBNA IgG and HHV-6-DNA positivity were retained in a predictive model of FCD risk; the combination had a stronger association than either alone. CMV-specific IgG concentration modified the association between an MS risk-related human leucocyte antigen gene and FCD risk. Six cases and one control had very high HHV-6-DNA load (>1.0 × 10⁶ copies/mL).

Conclusions

HHV-6-DNA positivity and high load (possibly due to inherited HHV-6 chromosomal integration) were associated with increased FCD risk, particularly in association with markers of EBV infection. With growing interest in prevention/management of MS through EBV-related pathways, there should be additional consideration of the role of HHV-6 infection.