实习期间护生焦虑情绪对免疫内分泌功能的影响

目的研究护理学生临床实习期间焦虑状况及焦虑与机体免疫内分泌功能变化的相关性。方法 92名正在实习的护生自愿参与研究,统一完成状态-特质焦虑量表问卷(STA I)、匹茨堡睡眠质量指数量表(PSQ I),同时检测部分免疫内分泌指标,包括血清皮质醇、淋巴细胞及亚群的百分比(CD 3、CD 4、CD 8、CD 4/CD 8、CD 19、CD 16+CD 56)、红细胞表面CD 35分子百分率等。采用SPSS 13.0软件进行数据分析。结果参与研究护生实习期间SA I和TA I分数与在校期间相比均显著增加(t=3.889,2.742;P均<0.01)。焦虑状态与学生主观睡眠质量指数呈正相关(r=0.456,P<0.001);与CD 3+T淋巴细胞百分率(r=-0.327,P<0.001)和CD 4+T辅助淋巴细胞百分率(r=-0.350,P<0.001)呈显著负相关;与血清皮质醇浓度无相关性。CD 3和CD 4细胞百分率在不同焦虑程度组间有显著差异(F=3.531,4.663;P<0.05)。结论临床实习期间护生焦虑水平增高。焦虑情绪可影响学生主观睡眠质量和机体淋巴细胞免疫功能。

The Effect of Nursing Intern Students' Anxiety on Immune-endocrine Function

Objective To study nursing students＇ anxiety condition in clinical practice and the effects of anxiety on immune-endocrine variables.Method A total of 92 nursing students in clinical practice were recruited.STAI and PSQI were administered,at the same time the immune-endocrine profile included the percentage of T lymphocyte and subsets（CD4,CD8,CD4/CD8）,B cell（CD19）,NK cell（CD16＋56）,molecule CD35 of red blood cell surface,plasma cortisol were measured.Result Nursing students＇ SAI and TAI scores were significantly higher in clinical practice than in school（t=3.889,2.742;P0.01）.Anxiety was positively related to badly subjective sleep quality（r=0.456,P0.001）;but negatively related to CD3（r=-0.327,P0.001）and CD4（r=-0.350,P0.001）;not related to serum cortisol.CD3 and CD4 were significantly different between three anxiety degree groups（F=3.531,4.663;P0.05）.Conclusion During clinical practice,nursing students＇ anxiety level is increaseing.Anxiety condition can effect students＇ subjective sleep quality and reduce lymphocyte immune function.