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目的探讨高考应激对机体的血清生化、免疫指标的影响及其与人类白细胞抗原-DQB1(HLA-DQB1)等位基因的关系。方法随机选取沈阳某重点中学27名学生,高考前1个月作为实验组和某学校开学2个月后的学生作为对照组。测定白蛋白、总蛋白、总胆红素、直接胆红素、尿素、肌酐、尿酸、葡萄糖、谷丙转氨酶、谷草转氨酶、碱性磷酸酶、转肽酶、钙、钠、钾、氯、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、IgG、IgA、IgM、C3、C4。采用全自动生化分析仪完成检测;HLA-DQB1采用PCR法检测。结果高考应激组白蛋白(50.1±1.6)g/L,葡萄糖(4.8±0.3)mmol/L,碱性磷酸酶(94.6±26.0)U/L,钙(2.4±0.1)mmol/L,钾(4.2±0.3)mmol/L,补体C3(1122.5±169.2)mg/L,与对照组比较,均明显升高,差异均有统计学意义(P<0.05);直接胆红素(3.3±1.4)μmol/L,谷草转氨酶(16.3±3.7)IU/L,总胆固醇(3.6±0.5)mmol/L,与对照组比较明显降低,差异均有统计学意义(P<0.05);HLA-DQB1各等位基因阳性携带和阴性携带者各检测指标水平差异均无统计学意义(P>0.05)。结论某些临床常规血清生化、免疫指标可以作为观察社会心理性应激程度的敏感指标。
Objective To investigate the effect of college entrance examination stress on serum biochemical and immune indexes and its relationship with human leukocyte antigen-DQB1 (HLA-DQB1) alleles. Methods A total of 27 students from a key middle school in Shenyang were randomly selected as experimental group one month before college entrance examination and two months after a school was started as a control group. Total albumin, total bilirubin, direct bilirubin, urea, creatinine, uric acid, glucose, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, transpeptidase, calcium, sodium, potassium, chloride, total Cholesterol, Triglyceride, High Density Lipoprotein, Low Density Lipoprotein, IgG, IgA, IgM, C3, C4. Using automatic biochemical analyzer to complete the test; HLA-DQB1 PCR method. Results The levels of albumin (50.1 ± 1.6) g / L, glucose (4.8 ± 0.3) mmol / L, alkaline phosphatase (94.6 ± 26.0) U / (4.2 ± 0.3) mmol / L and C3 (1122.5 ± 169.2) mg / L respectively, which were significantly higher than those in the control group (P <0.05) (P <0.05). The levels of HLA-DQB1 (+) micromol / L, aspartate aminotransferase (16.3 ± 3.7) IU / L and total cholesterol (3.6 ± 0.5) mmol / L were significantly lower than those of the control group There was no significant difference in the levels of alleles between the positive carriers and the negative carriers (P> 0.05). Conclusion Some clinical routine serum biochemical and immune indexes can be used as sensitive indicators to observe the degree of social psychological stress.