摘要
目的:当遇到紧张刺激,可影响生理、心理及免疫功能,产生的免疫反应也可以影响其他生理功能及心理感受,导致生理和/或行为的反应。综述国外对应激刺激时机体分子水平变化的研究现状,探讨免疫功能在心理应激过程中的变化及其意义。资料来源:应用计算机检索Medline1997-01/2003-12的与脑卒中早期康复相关文献,检索词“stress,immune,depression,neuropsychiatricdisor-der”,并限定文献语种为英文。资料选择:对资料进行初审,从中选取包括应激组和对照组的文献,然后选择是随机临床实验的研究和实验室实验的研究纳入标准。排除标准:非随机临床实验研究,重复的同一研究和综述类文献。资料提炼:共收集到43篇关于应激刺激时机体分子水平变化的随机对照临床实验和实验室的实验研究,25篇纳入标准。排除的18篇中7篇是重复的同一研究,11篇为Meta分析研究。25个实验分别对心理应激刺激时免疫细胞的变化,细胞因子及其受体的变化,免疫功能变化的神经内分泌因素进行了评价。资料综合:应激刺激对生理、心理及免疫功能影响的分子基础包括多种直接的信息网和神经内分泌及免疫细胞和免疫源性介质的反馈调节作用。①免疫细胞的变化:应激反应与神经激肽细胞活性抑制及淋巴细胞对有丝分裂原的增殖反应降低和IL-2、IFN-γ产生抑制有关;老年群体抑郁症与神经激肽-T细胞亚群升高有关;单核细胞的反应性氧作用系统细胞内水平与抑郁性紊乱患者的神经激肽细胞活性降低存在明显的相关性。②细胞因子及其受体的变化:心理性应激反应和精神病学疾病可危及免疫功能的安全,此现象的发生机理可能与免疫系统细胞因子的活性和其他炎症调节因子有关。③免疫功能变化的神经内分泌因素:细胞因子主动转运到中枢神经系统,也从神经胶质细胞中释放,激活中枢神经系统�
OBJECTIVE： Tension affects the functions in physiology, psychology and immunity. The immune reaction induced may affect other physiological functions and psychological feelings, resulting in reaction in physiology and/or behavior. The present state in the studies on organic molecular changes during stress at home and broad was synthesized so as to explore the change of immune function in psychological stress and its significance. DATA SOURCE： Relevant literatures on early rehabilitation of cerebral apoplexy were looked up in Medline from January 1997 to December 2003. The retrieved words： ＂stress, immune, depression, neuropsychiatric disorder＂, limited in English. STUDY SELECTION： By first examination of data, the literatures with stress group and the control involved were selected, and then researches on randomized clinical experimental study and laboratory experiment were ineluded. Excluded criteria： the researches without randomized clinical experiment, repeated research and synthetic literature were excluded. DATA EXTRACTION： Totally, 43 papers on randomized-controlled clinical experimental research and laboratory experiment on organic molecular changes in stress were collected and 25 papers of them were employed. Of 18 excluded papers, 7 papers referred to the repeated research and 11 papers are Meta analyzing study. Totally 25 experiments have evaluated the change of immunocytes, change of cytokines and their receptors and neuroendocrinal factors in change of immune function during psychological stress. DATA SYNTHESIS： The molecule mechanism of stress on physiological, psychological and immunological functions is based on feedback regulation of multiple direct information net, neuroendocrinal cell, immunoctye and immunological medium. ① Change of immunocyte： Stress is associated with inhibition of neurokinin cell activity, reduced proliferation and inhibition of lymphocyte to mitogen and to IL-2 and IFN-γ respectively. Senile depression is related with the increased subgroup of neurok
出处
《中国临床康复》
CSCD
北大核心
2006年第2期189-192,共4页
Chinese Journal of Clinical Rehabilitation
