认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响.docVIP

认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响 　　[摘要] 目的 观察认知行为疗法为主的综合护理干预对脑出血康复期患者焦虑情绪及对血清中巨噬细胞移动抑制因子（MIF）和脑源性神经营养因子（BDNF）的影响。 方法 选取106例脑出血康复期的患者分为两组，对照组53例应用常规护理干预，观察组53例在常规护理基础上加用认知行为疗法为主的护理干预。应用焦虑自评量表（SAS）分析干预前后的焦虑评分，应用ELISA法分析干预前后血清中MIF和BDNF的表达。评价干预对焦虑评分及血清中MIF和BDNF的影响。 结果 观察组干预后焦虑评分的下降值明显高于对照组，观察组干预后MIF的下降值明显高于对照组，观察组干预后BDNF的升高值明显高于对照组。结论 脑出血康复期患者积极应用认知疗法为主的综合护理干预，可以有效地缓解焦虑情绪，同时可以有效改善血清中与焦虑相关的MIF和BDNF的表达，有效提高疗效。 　　[关键词] 脑出血；焦虑；认知行为疗法；护理干预；MIF；BDNF 　　[中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701（2014）11-0070-03 　　[Abstract] Objective To observe the influence on anxiety scores， changes of MIF and BDNF in patients with cerebral hemorrhage of rehabilitation by cognitive behavior nursing intervention. Methods A total of 106 cerebral hemorrhage patients with rehabilitation were divided into the observation group and the control group with 53 cases in each. The control group were intervened by routine nursing methods， the observation group were intervened by cognitive behavior nursing intervention. The anxiety scores were analyzed by SAS questionnaire. The MIF and BDNF expression were observed by ELISA before and after treatment. The anxiety scores， MIF and BDNF expressions were analyzed in the two groups. Results The score changes of anxiety were higher in the observation group than that in the control group after nursing intervention. The expression changes of MIF and BDNF were higher in the observation group than that in the control group after nursing intervention. Conclusion The cognitive behavior nursing intervention can decrease the anxiety scores， improve the expressions of MIF and BDNF， is worthy to be applied in the clinical work. 　　[Key words] Cerebral hemorrhage； Anxiety； Cognitive behavior intervention； Nursing intervention； MIF； BDNF 　　脑出血是一种常见病、高发病，焦虑综合征是其恢复期常见的并发症之一，其主要表现为兴趣丧失、食欲降低、睡眠障碍、体重减轻、反应迟钝、易激惹，甚至发展成精神变态及人格分裂、自杀倾向等，发生率约为30%～50%[1]。Smith在1991年首次提出了负性情绪的巨噬细胞理论，认为负性情绪相关症状与单核/巨噬细胞过度分泌的细胞因子有关，同时，负性情绪发生与体内脑源性神经营养因子（BDNF）含量的表达亦密切相关[2]。本实验通过观察认知行为为主的护理干预