目的 利用局部一致性（ReHo）方法探測創傷后應激障礙（PTSD）患者在靜息狀態下是否存在著大腦功能異常。 方法 2010年5月－7月對18例未經治療的地震PTSD患者和19例同樣經歷地震但未患PTSD的對照者進行了靜息態功能磁共振成像（Rs-fMRI） 掃描。應用ReHo方法處理Rs-fMRI數據，得出PTSD患者的異常腦區，并將患者存在組間差異的腦區ReHo值與臨床用PTSD診斷量表（CAPS）、漢密爾頓抑郁量表（HAMD）和漢密爾頓焦慮量表（HAMA）分別進行相關分析。 結果 ① PTSD組ReHo顯著增加的腦區包括右側顳下回、楔前葉、頂下葉、中扣帶回，左側枕中回以及左/右側后扣帶回；ReHo顯著降低的腦區包括左側海馬和左/右側腹側前扣帶回。② 異常腦區中后扣帶回和右側中扣帶回ReHo與HAMD呈負相關（中扣帶回r=?0.575，P=0.012；右側后扣帶回：r=?0.507，P=0.032），其余腦區ReHo與臨床指標無明顯相關性（P＞0.05），左側海馬與CAPS的相關性相對其他腦區較大（r=?0.430，P=0.075）。 結論 PTSD患者在靜息狀態下即存在著局部腦功能活動的降低和增加，ReHo方法可能有助于研究PTSD患者靜息狀態腦活動。
【摘要】 目的 了解和分析玉樹地震傷員急性應激期睡眠問題。 方法 2010年4月，對90例玉樹地震傷員的急性應激反應采用創傷后應激障礙癥狀清單平民版(PCL-C)17項量表進行篩查評估，并應用SPSS 17.0軟件進行統計學分析。 結果 在PCL-C 17個條目中，提示睡眠障礙的條目2和條目13發生率分別為61.10%、63.30%，分別排列第5位、第3位，其得分分別與PCL-C總得分、閃回癥狀得分、回避癥狀得分及高警覺性癥狀得分均呈正相關(P值均lt;0.01)。 結論 睡眠障礙是地震傷員急性應激反應中的常見問題，需高度重視，并進行積極有效的處理。【Abstract】 Objective To learn and analyze the sleep disorders in acute stress of the wounded persons in Yushu earthquake. Methods The acute stress reaction of 90 wounded persons in Yushu earthquake were screened with post-traumatic stress disorder (PTSD) Checklist-Civilian (PCL-C) version-17 in April 2010. Sleep disorders were statistically analyzed with SPSS 17.0. Results In the 17 items of PCL-C, the incidences of the second and the thirteenth item which were related to sleep disorders were respectively 61.10% ranking at the fifth and 63.30% ranking at the third. Both scores of these two items had significant positive correlation with the total score of PCL-C and the scores of the flashback symptom, the avoidance symptom and the heightened alertness symptom (Plt;0.01). Conclusion Sleep disorder is a common problem in acute stress reaction of wounded persons in earthquakes, which needs high attention to be treated positively.
【摘要】 目的 調查成都市未成年犯管教所民警心理健康水平。 方法 2010年5月采用癥狀自評量表（symptom checklist 90，SCL-90）和健康調查簡表（short form 36 health survey questionnaire，SF-36）調查成都市某未成年犯管教所153名民警的心理健康水平，并對比相應人群的常模分數。 結果 未成年犯管教所民警SCL-90陽性率57.5%，SCL-90總分及各因子分均高于1999年修正常模、1986年全國常模（Plt;0.05）。SCL-90的人際關系敏感因子分與北京監獄民警常模差異無統計學意義（Pgt;0.05），偏執因子分低于北京監獄民警常模（Plt;0.05），SCL-90總分及其余因子分均高于北京監獄民警常模（Plt;0.05）；SCL-90總分及各項因子分男性高于女性（Plt;0.05），直接監管犯人者高于內務、管理工作者（Plt;0.05）；年齡lt;35歲者的抑郁、偏執、精神病性因子分高于年齡gt;35歲者（Plt;0.05）。SF-36各因子分均低于1998年四川居民、2005年上海公安局民警（Plt;0.05）；SF-36各因子與SCL-90總分、各因子均呈負相關（Plt;0.05）。 結論 應重視并改善未成年犯管教所民警的心理健康水平。【Abstract】 Objective To investigate and analyze the mental health of policemen in juvenile reformatory and their relationships. Methods The mental health of 153 policemen working in a juvenile reformatory were assessed by using symptom checklist (SCL)-90 and short form 36 health survey questionnaire (SF-36) in May, 2010. The data was compared with norm and other relative data, such as SCL-90 China norm, norm revised in 1999, SCL-90 of judicial police in Beijing, etc. Results The positive rate of SCL-90 of policemen in reformatory was 57.5%. The total score and factor score of SCL-90 were significantly higher than that of the China norm revised in 1999. Furthermore, compared with the judicial policemen in Beijing, except for the interpersonal sensitivity and paranoid ideation, the total score and other factor scores were significantly higher. The SCL-90 total score and various factors of the males were significantly higher than that of the females. The score of the guards was higher than that of charging of quarters and management. In youth (less than 35 years old) depression, paranoid ideation, psychoticism factor scores were significantly higher than that in the middle-aged groups. SF-36 factor score of the reformatory police was significantly lower than that of Sichuan resident in 1998, and also the policemen in Shanghai Public Security Bureau in 2005. And SF-36 factor score of the reformatory policemen had a significant negative correlation with the total score and every factor score of SCL-90. Conclusion We should pay attention to the juvenile reformatory policemen’s mental health and and improve it.