DIEN DAN Y HOC
Nghien cii'u khoa hpc
Btrdc dau danh gia roi loan lo au tren cac benh nhan
mac mot so benh ly dj iJng
Nguyin Van Ooan*, Trjnh Ngoe Anh**
TOMTAT
Budc diu danh gia rii loan lo au tren cac benh nhan mac mot si benh ly di dng tai khoa Di dng- MiSn djch lam sang Benh vien Bach Mai
Muc tieu; 1) Khao sat ehung vi ty le nhan each lo au d ngudi benh trong mot sdbenh ly di dng.
2) Danh gia mde do lo au tren ngudi benh trong mot si benh ly dj dng. Dat vin di: stress lo au cung cac benh ly di dng dang ngay cang gia tang, nhiiu nghien cdu gin day tren thi gidi da ghi nhan mil lien he gida lo au va cac benh ly di dng. Bdi tuang va phuong phap nghien cilu; 1. Dii tuang: 152 benh nhan dugc kham hay nam vien diiu tri dugc chin doan mot trong cac benh ly di dng tai khoa Dj dng - MDLS Benh vien Bach Mai (2007-2008); 2. Phuang phap: md ta cat ngang; Ke't qua va ban luan; 1. Vi dac diim nhan each lo au: Cac benh nhan mac benh ly di dng hiu hit cd dac diim nhan each lo au td mde vda din cao, dac diim nhan each lo au cao nhat gap d cac benh nhan do tudi >40 tuoi, la can bd cdng nhan vien chdc. 2. Vi mde do lo au: mde do lo au tang din theo tudi, mde lo au cao nhit d do tudi >40, benh nhan hen phi quan. Khdng cd su khac biet vi mde lo au gida 2 gidi, ngudi da lap gia dinh hay chua, khoang thdi gian mac benh di dng va viec cd hay khong cd benh ly man tfnh khac di kem. Ke't luan; cac benh nhan dj dng cd mde do lo au td mde vda din cao, tang din theo tuoi va khdng cd su khac biet mde do lo au gida 2 gidi, da lap gia dinh hay chua, cd hay khdng cd benh ly man tfnh khac di kem.
LDATVANDE
Cung vdi tdc do phat trien nhanh chdng ciia nen kinh te thi trudng la sy gia tang tinh trang d nhiSm mdi trudng, viec su dung tbudc va hda chat khong diing chi dinh, nhjp do sdng khan truang, nhiSu stress. CIc benh di ung nhu viSm miii dj iing, hen phS quan, dj irng tbudc... cQng vi vay ma cd xu hu(5ng ngly clng gia tang. Cung vdi sy gia tang ciia cic benh ly liSn quan dSn dj irng-mien djch thi stress v l lo au ciing da trd thanh phd biSn trong cude sdng bien dai. NbiSu nghiSn ciru gan
day da ghi nhan mdi liSn quan giira lo au va van dS dj irng d ngudi trudng thanh cQng nbu d thanh thieu nien [2].
O Viet Nam bien chua cd ngbien ciru nao vS van dS nay, vi vay nham gdp phan tim hieu thSm ve mdi liSn quan giira cic benh ly dj irng va tinh trang lo au, cbung tdi tien hinh nghiSn ciru dS tii nly vdi cic muc dich chinh:
l.Khdo sdt ehung vi ty le nhdn cdch lo du ff .ngudi binh trong mot sd benh ly di iing.
2.Ddnh gid miic do lo du trin ngudi binh trong mot sd benh ly di iing.
* Khoa Dj Ung - Miin dich lam sang - Benh vien Bach Mai
** Ldp Y6 - Dai hoc Y Ha Ngi
DIENDAN Y HOC
Nghien cifu khoa hpc
II. TONG QUAN
Di ung II nhirng trang thai khlc nhau ctia sy biSn ddi tinh phan ting cua ca the, m l mot trong nhiing biSu hien quan trgng la sy man cam ctia nd ddi vdi nhung tic ddng khlc nhau ciia mdi trudng.
Lo au la bien tugng phln iing ty nhien ciia con ngudi trudc khd khan, de dga ciia ty nhiSn v l xa hdi, la tin hieu bio dgng bio trudc mdt nguy hiS'm sap xay dSn.
Rdi loan lo au la su lo sg q u i muc trudc mdt tinh hudng xay ra cd tinh chat ma hd, lap lai v l keo dai gay anb hudng tdi sy thich nghi vdi cude song.
Trong Y van ThS gidi tiing cd nhiSu tai lieu ghi nhan vS mdi liSn he giira cle rdi loan tam ly lo au vl benb ly dj iing. Trong dd cd 2 hgc thuySt ldn da dugc nSu ra nhlm ly giai ve mdi liSn he nay [2].
-Hgc thuyet sinh vdt [2]
Hoc thuySt sinh vat cho rang cle loai hinh di ung vl cle roi loan lo au deu ed cle moi liSn he cbung vS hda hgc than kinh v l hda hgc can triic.
Dya trSn cic bang chirng nghien ciru cho tbay tre em hay xlu hd vl gugng gao thudng cd tang cudng hoat ddng ciia he than kinh giao cam, thSm vao do, cle bieu hien dj irng ciing nhu cic banh vi lo au dSu cd mdi liSn he vdi he thdng limbic vl true dudi doi-tuyen ySn (theo Kagan ciing cdng sy
1987,1988; Arcus, 1994). He thdng limbic liSn quan dSn qua trinh diSu chinb cam xiic va cd liSn he vdi true dudi doi-tuySn ySn nham kiem solt cle phan ung ciia ca tbS trudc cic stress cap (Matthew, 2001).
Mot gil thiSt khac lai cho rang lo au v l cle benh ly di irng cd mdi liSn he vS mat di truySn. CIc moi liSn he vS di truySn da dugc chi ra la cd thS ly giai tdi hon 75% mdi tuong quan (covariance) giira cle benh ly di iing v l cle trieu chirng tam benh hgc d cle tre em sinh ddi (Wamboldt, Schmitz, & Mrazek, 1998). Gil thuySt nly phii hap vdi cle nghiSn ctru ciia Slattery ciing cdng sy, 2002 va ciia Kagan (1991) trong dd cha me ciing cac thanh viSn khlc trong gia dinh cua tre bj benh ly dj irng di kem vdi rdi loan lo au cd ty IS mic benh ly di irng cao ban so vdi nhdm chirng.
-Thuyit nhan thiic-hdnh vi
Hoc thuySt nly nhan manh vai trd cua mdi
trudng trong sy tiSn trien ddng thdi ctia cle benb ly dj ung va rdi loan lo au. Hgc thuySt vS nhan thuc-hlnh vi da thira nban rang thuySt diSu kien hda kinh diSn da ly giai mdi liSn quan giira lo au v l dj iing, trong dd lira tudi tre em v l thieu nien da cd cac biSu hien dj irng (tir cac kich thich khong diSu kien) lo au trudc sy tii diSn cua cic biSu hien nly. Do dd tre se trai qua cam gilc lo au va sg hai (dip irng cd diSu kien) di kem vdi cle trieu chiing cua benh ly di irng (trd tblnb kich thich c6 diSu kien). Hai trong cic nghiSn cuu da cung cap bang chirng vl ung hd cho hgc thuyet nay la nghiSn cihi ciia Craske (2001) chirng minh rang tiSn subj hen ddng vai trd quan trgng trong sy tiSn triSn ciia cac rdi loan hoIng sg va chting sg khoang rdng (ago- raphobia), nghiSn ctru ciia Goodwin (2003) chi ra rang cac con hen dy bao trudc cho sy tii diSn ciia cle con hoIng sg.
Mdt sy ly giii khlc tir hgc thuySt nly cho rang biSu hien di kem ciia rdi loan lo au trong cle benh ly dj iing liSn quan dSn mdi trudng va viec gay dyng hinh mau tir cha me. Ket qui ttr cle nghiSn ctru ciia Butz and Alexander (1993), Bussing ciing cong sy (1996), vl Slattery (2002) da chiing minh rang cac tre bat chudc theo cle phln iing lo au cua cha me trudc cic kich thich gay dj iing. ThSm vio do, cae nghiSn ciru ctia Gupta (2000), Wamboldt ciing cong sy (1998) da dua ra them cac bang chiing cho rang mirc dd.lo au cao d cha me ddng vai trd quan trong trong viec gia tang mirc lo au d tre.
Nhu vay d ca hai hgc thuySt trSn deu cd sy ly giai cho mdi lien he giira rdi loan lo au v l cac benh ly dj iing, tuy nhiSn ca bai hgc thuySt nay dSu e6 nhung ban che, ddi hdi can cd cic nghiSn ciru sau hon nhlm cung d p thSm cac bang chiing iing ho.
- Cdc nghien ciiu tren thi giffi
Trong thyc banh y hgc tren the gidi da cd kha nhiSu cic ngbien cuu ban luan vS cic khia canh khac nhau ciia mdi lien quan giira roi loan lo au va cle benh ly dj (ing
Theo nghiSn ciiu ciia Donaldson va Rosen (1966) vS benh ly phu mach di truySn da nhan thay stress va lo lu II mot trong nhDng ySu td nguy ca lam gia tang tin sd ciia cic dgt biing phlt cSp tinh ciia benb [7].
Theo nghien ciru ciia H. Hashizume ciing cdng su trich ra tu tap chi chuyen dS Da liSu ctia Anh
4 6 IY HOC LAM SANG So 46 (Ttiang 11/2009)
Nghien cii'u khoa hpc
Qudc [9] thi stress va cle rdi loan tam ly ma hay gap nhat la lo au llm nang ne thSm cle bieu hien ngoai da trSn cic benh nhan cd viSm da tiSp xtic, tir dd cac tic gil da dat van dS vS mdi liSn quan giira lo au vdi cle rdi loan boat ddng ciia he thdng miSn djch. Trong cle nghiSn cuu cua minh, cic tic gia da sir dung thang lo au Spielberger nham dinh gil mirc do lo au trSn cic benh nhan cd va khdng c6 cic benh ly di irng. Va ket qua tir cle nghiSn cuu dd da cho thay, mirc do lo au gap d cic benh nhan cd benh ly viSm da tiSp xiic dac biet cao hon so vdi cle benh nhan khdng cd benh ly dj irng nhat II vS chi sd nhan cleh lo au (STAI-T) nham danh gil miic do lo au trudng diSn d cic benh nhan nay.
Ciing ddng thdi trong nghien cuu nay, cac tie gia da tiSn hanh danh gil va nhan thay lugng IgE toln phan trong buySt tuang tang song song ciing vdi mirc do lo au danh gil theo chi sd nhan each lo au (STAI-T), ty IS STAI-T/STAI-S, trong khi lai khong cd mdi liSn quan ddi vdi chi sd trang thai lo au (STAI-S), mirc do ngira trSn lam sang, sd lugng bach cau li toan trong mlu ngoai vi va ty IS Thl/Th2 ty IS nghjch holn toln vdi muc do chi sd nhan elch lo au va ty IS STAI-T/STAI-S. Sy tdng hgp IgE trong mlu la sy dieu boa ve chirc nang giira 2 loai tS bao Thl-te bio san xuat Interferon gamma va Th2-tS bao san xuat Interleukin gamma, khi cle tS bio Th2 boat ddng manh ban, ca thS se tang tdng bgp IgE. Cac tac nhan gay stress tam ly va lo au dSu tic ddng thdng qua true dudi ddi- tuySn ySn lam tang cudng giai ph6ng hormone tuySn vd thugng than II cortieoid va kich thich he thdng than kinh giao cam llm tang mirc giai phdng catecholamine. Ca hai loai hormone tren deu cd tic dung diSu hda ddi vdi sy biet boa vS chirc nang ciia cac tS bao T cting cic tS bio miSn dich khlc. Do dd, nhiSu kha nang cic stress cap tinh v l rdi loan lo au lap lai trudng diSn trSn cle benh nhan viSm da tiSp xiic llm gia tang mirc do lo au trudng diSn trSn cac benh nhan nly vl cd the da kich thich llm tang cudng dip irng mien djch qua ele tS bao Th2. Tir dd cac tic gia riit ra kSt luan td nghiSn ctiu nly va cho rang cic benb nhan cd benb ly viSm da tiSp xiic cd miic do lo au cao ban so vdi cic benh nhan khong cd benh ly dj ung va d nhtrng benh nhan nly miic do lo au trudng diSn ctia hg cao se lam tang cudng mirc
tdng hgp IgE trong buySt tuong thdng qua xu hudng lam tang boat ddng cua cic tS bao Th2 [4][5][6][12].
Gin day nhit cic ngbiSn cuu ciia Hashizume Cling cdng su [10] da cho thay nhirng benh nhan cd bieu hien dj ung thudng bdc Id cic rdi loan vS tam ly dac trung bdi lo au, tram cam v l hung cam. CIc stress cam xiic llm khdi phlt cac trieu cbung ciia benh di irng khdng chi bdi lam gia tang muc do lo au m l cdn gay rdi loan chirc nang diSu hda miin djch. CQng theo cic nghiSn ciru ciia cle tic gil thi cle benb nhan cd rdi loan lo au thudng biSu bien mgt mdi liSn quan mat thiSt vdi cle biSu hien lam sing ciia benh ly dj trng.
CIc stress cap vdi tinh chat lap di lap lai vl dien biSn man tinh cd xu hudng anh hudng rd ret dSn dien biSn benh ciia benb nban ban la cic lo au tai thdi diSm hien tai. Cac rdi loan vS tam ly nay da llm gia tang d i p trng miSn djch qua tS bao Th2 do sy rdi loan diSu hda ciia he thdng than kinh miSn dich dan dSn llm tram trgng them cac biSu hien benb dj ung. Tandospirone, mdt chat ddng van tai receptor 5-hydroxytryptamine IA vdi tie dung giai lo au, chdng tram cam da c6 tic dung cai thien rd ret cle trieu chirng ctia benh dj ung thdng qua viec kiSm solt tblnb cdng cac rdi loan vS cam xiic [11] [13].
Cho dSn nay viec tim kiSm cac phuong pblp dieu trj mdi, dac hieu theo ca chS benh sinh, cd hieu qua, cd chat lugng, ban chS cic diSn biSn khdng mong mudn, dac biet II nhCng van dS anh hudng tiSu eye liSn quan dSn cle benh ly dj irng dang la hudng phan dau ciia cic nhl khoa hgc chuySn nglnh trSn toln the gidi. Tir nhirng kSt qua nghiSn ciru trSn da md ra mdt hudng nghiSn ciru mdi vS phuong thirc can thiep diSu trj trong cic benh dj irng do II cle can thiep vS tam ly nhu thudng xuySn theo ddi dinh gil, kiem solt mtre do lo au di kem vdi biSu hien benh dj ung nhu II nSn tang dS gdp phan lam cii thien tinh trang benh dac biet tren cic benh nhan dj irng cd biSu hien rd ring cle rdi loan vS lo au [8].
III. DOI TU^UNG VA PHITDNG PHAP NGHIEN CITU Chiing tdi chgn 152 benh nhan dugc khIm hoac nam vien diSu trj tai kboa Dj iing miSn djch lam sang, Benh vien Bach Mai. Benb nhan
DIENDAN Y HOC
Nghien cu'u khoa hpc
dugc chan doan mdt trong sd c i c benh di ung sau: viSm mui dj irng, hen phe quan, dj irng tbudc, dj ung thuc an, dj irng my pha'm, dj irng hda chit, viSm da tiSp xtic... theo diing tiSu chuan cha'n doln, tudi 15-85, ty nguySn tham gia. Loai trir cic benh nhan: benh nhan khdng dti tiSu chuan chan doln mgt benh ly di ting nio, benh nhan nhd tudi (<I5 tudi), cd cic benb ly kSm theo khdng thich hgp cho nghiSn cuu (rdi loan phlt triSn tam than...), khdng ddng y tham gia.
Phuong pblp nghiSn cuu la md ta cat ngang.
Phuang pblp thu thap thdng tin bang phong van tryc tiSp theo bd eau hdi va tap trac nghiSm dinh gil mirc do lo au ciia cac benb nhan dya vio cle cht so trang thai lo au vl chi sd nhan each lo au theo thang lo au Spielberger [1].
Thang lo au Spielberger do Charles Spielberger pblt minh ra vio nam 1970 bao gom
40 cau hdi trie nghiSm de danh gil muc do lo au tai thdi diSm dugc phdng vln (chi sd trang thii lo au STAI-S) va muc do lo au trudng diSn (cbi so nhan elch lo au STAI-T) vdi cbi chua day 10 phiit. So vdi cic thang dinh gil lo au khlc, cle cau hdi trong bd cau hdi cua Spielberger khdng bi anh hudng kSt qui bdi cle trieu chiing thyc thS ciia benh nhan do dd la tbang lo au duge sir dung rdng rai nhat trong cac nghiSn ciru vS lo au va c6 thS Ip dung d hau khap cic benh nhan thugc moi chuySn khoa trSn lam sing. Thang danh gil nly da dugc dich ra ban 40 thu- tiSng trong dd cd ban chuan hda tiSng Viet ciia Bd mdn Tam ly Y hoc, Trudng Dai hgc Y HI Ndi [1].
Pban loai muc do lo au theo thang Spielberger:
<30 31-45 46-64
>64
Lo au miic do thap Lo au miic dd vita Lo au miic do cao
Lo au CO xu hudng benh ly IV. KET QUA VA BAN LUAN
- Danh gil cbung: kSt qua nghiSn ciiu thu dugc trSn 152 benh nhan mac benh ly di irng nhu sau:
!,•
So benh nhan Ty le (%)
Thap 8 5,26
Viirc dd chi sd n h a n each lo au Vtra
83 54,61
Cao 60 39,47
Benhly 1
0,66 KSt qua nay cho thay chi cd 5,26% sd benh
nhan II cd mtic do lo au thap (khdng ding ke) con cd tdi gan 95% (144/152) benh nhan cd mirc lo au tu vira trd len trong dd lo au tir muc do cao trd ISn cd tdi 61 benh nhan (chiSm 40%).
Muc do chi sd nhan cleh lo au trung binh ctia man nghiSn ctru la 44,11 ± 9,307 tuc II d
gidi ban tren ciia muc lo au vira.
Day cd thS ndi la cac con sd ding bio dong v l gan tuang ty vdi kSt qua nghiSn ciru ctia Stauder (2002) khi dng thu dugc trSn 646 benh nhan dj ung vdi mirc do lo au trung binh II 42,9
± 10,7 [3]
- Dinh g i l muc lo au theo nghS nghiep:
Ngbe nghiep
CInbg Lam rugng Hgc sinh Noi tra Khac Tong sd
Mirc do cbi sd nban each lo au (%) Thap
3(5) 1(5) 2(8) 2(40)
0 8
Vita 32 (48)
14 (48) 11(78) 2(40) 24 (72)
83
Cao 31 (47) 14 (47) 4(14)
1(20) 10 (26)
60
Benb ly 0 0 0 0 1(2)
Tong sd 66 29 17 5 35
1 152
4 8 IY HOC LAM SANG So 46 (Ttiang 11/2009)
Nghien cii'u khoa hpc
Trong 2 nhdm nghS nghiep chinh ciia mau nghiSn eun cung chinh la 2 nhom nghS nghiep co ty IS benh nhan cd chi sd nhan cleh lo au mirc do cao la nhiSu nhit (47% can bd cdng nhan viSn chuc v l 47% ngudi lam rudng).
Trong sd cic benh nhan cd chi sd lo au d mtre cao cd dSn 5 1 % la cin bd cdng nhan viSn chirc.
- Dinh gil mirc do lo au theo tudi
STAI-T n
Do tudi
<20 Mean 42± 10
22
20-29 Mean 41± 11
21
30-39 Mean 41 ± 8
20
40-49 Mean 48 ± 11
23
50-59 Mean 4 5 ± 9 25
60-69 Mean 46 ± 8
30
>70 Mean 45 ± 7
11
Trudc hSt khi tien hanh nghiSn cihi mdi tuong quan giira mirc do lo au theo tudi chiing tdi nhan tbay miic do lo au ctia cic benh nban tang dan tbeo tudi vdi miic y nghla thong kS (p = 0.007 theo Pearson test). Trong dd cic nhdm tudi ttr >40 tudi hau hSt dSu cd mde do lo au ttr muc cao trd ISn (trung binh > 45).
Nhu vay, van dS rdi loan tam ly lo au nSn dugc dac biet quan tam vdi cle benh nhan di irng tu tudi trung niSn trd di.
- Dinh gil theo benh ly dj ling da (dang) mac: •
n Tudi STAI-T
Benb ly di dng Di itng tbudc
Mean 74 45 ± 2 1 42 ± 10
Hen phe quan Mean
65 56 ± 1 5
46 ± 9 4- Trong 152 benh nhan dugc nghien cuu 2
benh ly gap chti ySu va ndi bat blng dau II dj irng tbudc (74 benh nhan chiem 48,68%) va hen phS quan (65 benh nhan chiem 42,76%), cac benh ly dj ling khlc chi chiSm 8,56% (13/152 benh nhan).
+ Trong sd 74 benh nhan dugc chan doln dj iing tbudc ty IS nam/nir la 54/46, do tudi tmng binh II45
± 21. Chi so nhan each lo au tmng binh II42 ± 10.
-I- Trong sd 65 benh nhan hen phe quan dugc chan doan ty IS nam/nir II 49,2/51,8, do tudi trung binh la 56 ± 15. Chi sd nhan each lo au tmng binh II46 ± 9.
-I- Tir kSt qui thu dugc cho thay cle benh nhan hen phS quan co xu hudng lo au trudng diSn vdi mtJC do cao ban so vdi cic benh nhan dj irng tbudc (Mann Whitney test p <0,05). Tuy nhiSn kSt qua tren day co thS' chua cbinb xlc do cic benh nhan hen phS quan cd do tudi cao ban han so vdi cic
benh nhan dj irng tbudc.
- CIc ket qua khlc:
-I- Dinh gil theo gidi: chi sd nhan cleh lo au d nam la 44 ± 10 va d nir la 44 ± 8.
KSt qua nghien ciin cho thay sy khac biet vS muc do nhan each lo au giiJa 2 gidi la kbdng ding kS (Mann Whitney test p>0,05).
-I- Dinh gil theo tinh trang hdn nhan:
Chi sd nhan cleh lo au trung binh ciia 127 benh nhan da lap gia dinh la 45 ± 9 va ciia 25 benh nhan chua lap gia dinh II 42 ± 9.
Nhung ngudi cd gia dinb cd mirc do lo au khdng khlc biet mgt cleh cd y nghTa so vdi nhirng ngudi chua lap gia dinh (Mann Whitney test p > 0,05).
-i- Danh gil theo cd hay khdng cd benh ly man tinb khlc kem theo
KSt qui cho thay nhirng benh nhan cd benh ly
DIENDAN Y HOC
Nghien cifu khoa hpc
man tinh kem tbeo (nhu viSm da khdp dang thap, lupus ban do, dii thIo dudng, tang huy St Ip... ma khdng phai benb ly dj ung) khdng cd khlc biet ding kS vS miic do lo au so vdi nhimg benh nban kbdng cd benb ly man tinb kem tbeo (Mann Whitney test p>0,05).
-1- Dinh gil theo khoang thdi gian bj benh. kbdng cd sy khlc biet ding ke vS mirc do lo au giiia cac nhdm bj benh vdi khoang thdi gian bj benh khlc nhau (cle nhdm bi benh <1 nam, 1-5 nam, 5-10 nam va >10 nam). (Kruskal Wallis test p>0.05).
V. KET LUAN
Qua nghiSn ctru d i n h g i l budc dSu vS roi loan tam ly lo au tren c i c benh nhan c6 benh ly dj iing nhu trSn chiing toi di dSn mdt sd kSt luan sau:
- Ve dac diem nhan c l e h lo au: cac benh nhan m l c benb ly dj ung ban hSt cd dac diem nhan c l e h 10 au tir mirc vtra dSn cao, dac diSm nhan each lo au cao nhat gap d c l e benh nhan do tudi >40 tuoi, 11 can bo cdng nhan viSn chtrc.
-VS mtre do lo au: muc do lo au tang dan theo tudi, mirc lo au cao nhit a do tudi >40, benh nhan hen phS quIn. Kbong c6 sy k h l c biet vS mirc lo au giira 2 gidi, ngudi da lap gia dinh hay chua, khoang thdi gian mac benh dj iing va viec cd hay khong cd benh ly man tinb k h l c di kem.
TAI LIEU THAM KHAO
1. Cdc test trac nghiem tdm ly Bd mdn Tdm ly Y hoc trudng Dgi hoc Y Hd Ndi 1999.
2. AbbyH.Friedman and TracyL.Morris (2006) Allergies 4.
5.
and Anxiety in Children and Adolescents: A Review of the Literature. Springerlink 2006
3. Adrienne Stauder, Munika Kovacs (2002): "Anxiety Symptoms in Allergic Patients: Identification and Risk Factors "
Buske-Kirschbaum A, Geiben A, Hellhammer D.
Psychother Psychosom (2001) Psychobiological aspects of atopic dermatitis: an overview; 70:6-16.
Buske-Kirschbaum A, Gierens A, Hollig H et al (2002) Stress-induced immunomodulation is altered in patients with atopic dermatitis. Journal of Neuroimmunology; 129:161-7.
6. Del Prete G (1992) Human Thi and Th2 lympho- cytes: their role In the pathophysiology of atopy.
Allergy; 47:450-5.
7. Donaldson VH, Rosen FS (1966) Hereditary angioneu- rotic edema: a clinical survey. Pediatrics 37:1017.
8. EricB.Weiser (2007) The Prevalence of Aiulety Disorders Among Adults with Asthma: A Meta- Analytic Review. Springerlink 2007
9. H. Hashizume; T. Horibe; A. Ohshima, T. Ito; H Yagi;
M. Takigawa (2005) Bristish Joiinal of Dermatology 152(6) 1161-1164. Blackwell Publishing
10: H. Hashizume, Hideo, Takigawa, Masahiro (2006) Current Opinion In Allergy & Clinical Immunology 6(5): 335-339.
11. Paul - Fundamental Immunology 5th edition (2003) Chapter 3
12. Rostalng L, Tkaczuk J, Durand M et al (1999) Kinetics of intracytoplasmlc Thi and Th2 cytokine production assessed by flow cytometry following in vitro activation of peripheral blood mononuclear cells. Cytometry; 35:318-28.
13. Roy Patterson (2002) Patterson's Allergic Diseases 6th ed Chapter 4.
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SUMMARY
INITIAL EVALUATION OF TRAIT AXIETY ON ALLERGIC PATIENTS AT DEPARTMENT OF ALLERGOLOGY AND CLINICAL IMMUNOLOGY IN BACH MAI HOSPITAL
Introduction: stress, axiety along with allergic diseases have been becoming more and more common, many studies all around the world have confirmed the relasonshlp between anxiety and allergic diseases. Object and method: I. Object: 152 out-patients and in-patients diagnosed one of some allergic diseases at the Department of Allergology and Clinical Immunology (2007-2008). Method: Cross-sectional surveys. Goals:
1. Generally Investigate on levels of trad anxiety in allergic patients. 2. Evaluate scores of trad axiety in aller- gic patients. Results and discussions: 1. Levels of trad axiety: generally, allergic patients had moderate to high level of trad axiety; highest levels of trait axiety were seen in patients who were officials at the age over 40. 2. Scores of trad axiety: scores of trait axiety increased with ages, highest score were seen in patients at the age from 40-49 and had asthma; there were no difference between sexes, different marital status, duration of allergic diseases or whether having associated non-allergic chronic diseases or not. Conclusions: allergic patients had moderate to high level of trad axiety; scores of trad axiety increased with ages; meanwhile there were no difference in level of axiety between sexes, marital status or whether having associated non-allergic chronic diseases or not.
5 0 IY HOC LAM SANG So 46 (Thang 11/2009)