Y HQC VigT NAM T H A N G 10 - 3 6 1/2012
NGHIEN CUfU TRANG THAI T H ^ N KINH THOC VAT VA CANG T H & N G CAM XUC CUA SINH V I £ N DAI HOC Y THAI B I N H
NguySn Thf Hi§n«, TrlSn DSng Dong**,VUc^ng Th{ H6a*
T 6 M TAT
Mgc tidu cua nghldn ciTu niy l i xic djnh trgng thii than kinh thUc v§t vd mu'c dd cSng thing cdm xuc d sinh vien Y. Nghidn CLTU dU(?c ti^n hinh trdn 600 sinh vien cic khoi tir nSm thCr 1 (Y J d?n nim thiT S (Yj) cua tn/dng D^i hpc Y Thii Binh, mdi khoi 120 sinh vign, trong do c6 60 nff v i 60 nam. Tinh tr?ng cing thSng cim xuc(tr?ng thii stress) du'dc dinh gii theo trSc nghidm Splelberger. K€t qui nghien ciiU cho thSy trang thii cUdng giao cam 6 Sinh vien glim din tiT nSm thir nhSt den nim thu' 5. Tr^ng thii cUdng giao cim 6 sinh vien khdi Y, chiem ty' l§ thSp hdn so vdi t i c khoi khic. Ty le trang thii thSn kinh thut v^t cUdng giao cam d sinh vidn nu" (47%) cao hon so vdl d sinh vien nam (37%), vdl p<0,05. Sinh vien c6 bieu hl^n cua tr^ng thii c^ng tiling than Idnh c^m xuc thudng xuyen d mut vua l i 58,8%, d mult cao l i 37,5%. Miit do lo 3u cao thUdng xuy@n d sinh vien nim thii" nhSt, ndm thii" 2, nim thiJ" 3, nim thu"
4 vd nim thir 5 l i 40%; 33,3%; 50,0%; 30,8%; 33,3%.
Sinh vien khoi Yj o6 ty le cSng ttidng cam xuc cao nhieu hdn sinh vi§n cac khdi Idiac (p<0,05).Ty ie sinh vi§n nff 00 mut dp cing thSng cam xuc cao va xu hudng benh ly nhieu hdn so vdi d sinh vien nam (OR=0,6; 95% 0=0,4- 0,8; p<0,05).
(Til'khoa: 5tress,autonomlc, students, medical.) SUMMARY
A Study of autonomic nervous state and anxiety of the students in Thaibinh Medical University
/\im of this study is to evaluate autonomic nervous state and anxiety state of the students in Thaibinh Medical University. The study was carried out on 600 students from the first year (Yl) to the fifth year (Y5) of this university, 120 students (60 males and 60 females) for each year student. Anxiety state (stress state) was assessed by uang Spielberger's scale. Results showed that overactive s^pathetic nervous state of student was declined from the first year (Yl) to the fifth year (Y5). Proportion of overactive state in the fiaurth year students was lower than other students. The proportion of overactive sympathetic nervous state (47%) of female students was significantly higher than that of male students (37%), p<0.05. Students with moderate level of anxiety accounted for 58.8%, with severe level accounted for 37.5%. Severe level of anxiety of the fir^ second, third, fourth and fifth year students were 40%; 33.3%; 50%; 30.8% and 33.3% respectively. The third year students had a higher severe level of anxiety than other students (p<0.05). Female students had a
*Tru&ng Dai hoc Y Thai Binh **Hoc vien Quan y Phin bl^n khoa hgc: PGS.TS. Ld Vdn Sdn
higher severe level of anxiety and a larger pathok)gical tendency than male students (OR«0.6; 95%a=0.4-0.8).
I. OAT V X N O I
Sinh vidn Id mpt t^ng Idp xa hpi, mQt iiTc lU0ng quan trpng doi vdl mot the ch6 chinh tri.
Sinh vi&n ngay nay phdi thUcJng xuyen doi mit vdi cudc c^nh tranh gay go, quyet liet cua kinh te thj trudng khu vUc va todn cau, ma thyt chat &
cgnh tranh ve tdi nSng, tri tu$ con ngudi, trong khi dSt nUdc chung ta dang con 6 diem xulft phat thSp. Trong sudt qud trinh hpc tap, hoat dpng nghien cCi^ khoa hpc vd ren luyen nghS nghi^
tUOng lai, sinh vien chju nhieu tac dong tif moi trudng xa hpi va qua trinh hpc tap, d3c U ^ la sinh vien cac trUdng dai hpc Y [6], [1]. Nguyen nhan gay cSng thSng dUOc Hashmat [1] tim thay tren sinh vien Y la do chUOng trinh hoc qua tai (90,8%), thieu tap the dye (90%) va thdi gian dai cLia cac cupc thi (77,5%). Oieu nay cho thay cac yeu to hpc thuat la nguyen nhdn dUdc nhan thay ro hdn cua stress trorw sinh vien Y. Cang thSng than kinh cam xuc dan den tSng tiet cac npi tiet to, trong do c6 catecholamin vk Cortisol (nhffng chat vu^ c6 Idi lal viJS co hai doi vdi cd the neu bai tiet vdl so lUdng Idn vd keo dai), tSng sifc ep tam ly vdi hp [5]. Trang thai stress co the xuat hien d nhieu mut do i<hac nhau phy thuoc vao cac yeu to moi trudng, dieu kien hpc tap va cac yeu to xa hpl. Cac dap utig vcH stress con thay doi tuy theo sy nhan djnh, trai n g h l ^ cam xuc vd nhdn thiit, hanh vi (doi pho thfch hdp) cua ca nhan doi vdi sy kien gay stress. Vi vay cac nghien cifu ve trang thdi than kinh Uiyt vat va stress d sinh vien Y la cd sd giup cho cac nha quan ly y te can thiep dy phdng cho sinh vien Y nhSm ng3n chdn nhffng hau qua tieu cUt'cAa cdng thSng va cdl thi^n phong each song eiia h?
bSng cdch thue day cdc nguon lye ca nhdn cung nhu xa hpi. Day la yeu to rat quan trpng trong viec dat dugc muc tieu ehSm sde siit khoe ^^
ndng cao tai san tri tu^ cua sinh vien. Chung toi thyc hidn de tal nay vol myc tieu ddnh gia trang thai than kinh thUc vat va mut do cSng thang cam xuc d sinh vien Dai hoe Y Thai Binh.
Y HQC VigT NAM THANG 10 • s6 1/2012 II. OOI TUONG vA PHUONG PHAP NGHIEN ClJfU
2.1. B61 tu'dng nghien cu'u
Doi tUdng nghidn cifu la 600 sinh vien eae Idp dao tao bac sy da khoa he chfnh qui ngUdi Viet Nam, eae khoi tff ndm thff l (Yi) den ndm thff 5 (Ys) cua trudng Oai hpc Y Thai Binh, tudi tff 18 den 25. iv|oi khoi 120 sinh vien. Chiing toi khdng chpn sinh vien khoi Ye vi sinh vien Yg chuan bi ra trudng va con thyc tap tot nghiep tai c6ng dSng nen khd tap trung.
Tieu chuan chpn doi tffdng; cac ddi tffdng dddc \ify chpn vao nghien eihj la nhffng ngffdi eo chi so BMI, mach, huyet ap, thfnh lyc vd thi iffc trong gidi han binh thffdng. Ooi tudng nghidn cffu khdng mac cac benh cap va man tfnh, dac bi?t la cac benh tim mach, than kinh va tam than; khong diing thudc an than ho3c chat kfch thfch 3 ngay trffdc va trong qua trinh nghien cu\j;
tinh nguyen tham gia nghien cuU va tuan thii dung qui trinh nghien cffu.
2.2. Phi/tfng phdp nghien cili'u 2.2.1. Tfiiiike nghiin cuti:
Nghien cuTu dffdc tien hanh theo phffOng phap mo ta cat ngang, so sanh doi chifng ed phan b'ch so lieu (^nh Iffdng.
2.2.2. Cd miu vi phu'dng phip chpn miu
Ap dung theo Phan Van Duyet va Le Nam Tra [1] nghien eutJ cac chi so sinh hpc tien hanh chpn cd mau eho nghien cifu dam dong theo cong thffc sau:
"~ N.d'+t'.S'
Trong dd:
n la so ca the cua mau can liy.
N la so ca the ciia toan bp dam dong.
S la dp lech chuan tinh theo % gia tn trung binh (hay eon gpi la h^ so bien thien CV).
t la tri so t tffdng ffng vdi dp tin cay chpn trffdc ciia ket qua.
_ d la sai so cho phep ciia tri sd trung binh ( X ) chpn trffdc.
Chpn sai sd cho phep cua ket qua nghien cifu \h ±5% cua trj sd trung binh, dp tin cay cua ket qua la 99% (ket qua dung 99% c^c t:rffdng hdp thi tr! sd t de p = 0,01 ifng vdi n=oo la 2,58). Theo dd ta se tfnh dffOc h? s6 bien thien cy = 20% ciia gia tri trung binh (,X). Moi khoa dao tao bac sT da khoa he chfnh quy eua trudng Dai hpc Y Thai Binh chlgu sinh khoang 300 sinh vien (N=300) nen sd c^ the cua mau ran chpn ia:
20^2,581300 300.5'+2,58'.20' "
Theo each tfnh c3 mau tren, trong nghien eu\i nay chung toi iUa chpn 120 sinh vien cho moi khdi (gBm 60 nam va 60 nD), tdng so doi tffdng nghidn euU ciia 5 khoa la 600 sinh vien de do dac eae ehi so sinh hpc nen dam bao cd mau nghien cffu.
2.2.3. dc chi so nghiin ahi - Trang thai than kinh thyc vat, - Trang thai c§ng thang cam xuc thffdng xuyen (trang thai stress)
2.2.4. Phu'dng tiin nghiin cuti va phtfdngphip do
- Tfnh ehi so Kerdo = (1-d/p) x 100 Trong dd: d la huyet ap tam trffdng, p la tan sd mach tnang mpt phiit. Cac chi so mach va huyet ap do theo phffdng phap thffdng qui.
Phan ioai trang thai than kinh thffc vat theo ehi sd Kerdo: tff -15 den +15: can bang; >+15:
cffdng giao cam; <-15: cffdng phd giao cam.
- Tinh trang cang thang cam xuc theo trac nghiem Spielberger. Mffc dp cang thang cam xiie dudc danh gia theo thang diem sau:
Bang 2.1. Mu'c do cinq thSnq cam xuc theo Spielberger Mii'cdp
Tonq so diem Thap
<30 Vira 31-45
Cao 46-64
C6 xu hu'dng benh ly •
>64
* Dettanh deyiu to nhieu: cac chi so duOc do vao ngay nghi, each xa cac cuoc thi it nhat 1 thang, tal phong Sklllslab. Phong dam bao thoang mat, yen finh. Moi doi tuttng duHc do_mach, huyet ap tnldc, sau d6 thi/c hien trac nghiem Spieibenger vao ciing mot thdi diem trong ngay, moi buoi 30 em.
2.3. Xu* l^ s3 l i | u : Cac so iieu duttc xti' ly bSng may vi tfnh tren phan mem Epi Info 6.04 va SPSS theo phuBng phap thong ke y sinh hoc.
III. KET QUA N G H I S N cCru
Ket qua nghien cuU du'dc trinh bay tren cac bang 3.1-r 3.4 va hinh 3.1.
Y HQC V I 6 T N A M T H A N B 10 • S 6 K2012 Bing 3,1. M6t so chi sS vg tim - mach cua sinh vl6n, (A* ± SD)
Nam 300 79.85±9,02 116,03±20,14
70.71±7,56 10,51tl3,79
Nff n°300 79.8119.02 107.60±11,86
67.77±B,19 14,7±13,64
>0,05
<0,05 Ket qui d bing 3.1 cho thSy khong co si/ khic bl?t ve tan sS m?ch glDti hai gidi. HA tam thu, HA tam tru'dng cua nam cao hdn so vdl d ni? c6 y nghia thSng ke vdl p<0,05. Chi so Kerdo ciia niTcao hdn nam co y nghia thSng ke vdl p <0,05.
Bina 3.2. ejc dilm ve tranq thii thSn kinh thu'c vat ciia sinh vian. theo qidl.
Trang t h i l T i n V C3n bSng Cuftnq giao cAm Cuftnq phd Qiao cim
Nam (A)
37,0
NCtB)
»/o 50,0
3,0 PCA-B)
>0,05
<0,05
>0,05
Chung 53,5 42,0 1,5
Tonq conq 100.0
cic so lieu d bing 3.2 cho thay tr?ng thai than kinh thi/c vat can bing chiem ty le cao n h S d i i hai gidl, trang thii cu'dng phd giao cim chlem ty 1$ it nhat. So sanh giu'a hai gidi thay ty I? tr?ng thai TKTV can bSng d nam cao hdn so vdi d nu' (p >0,05), cdn ty I? trang thii cu'dng giao cam d nff tao
hdn so vdi d nam cd y nghia vdi p <0,05.
• Cu'&ng ph6 gtao cdm O C^yfyng giao dm DCan bang
Hlnh 3.1. Bilu do trang thai thin kinh thut v$t cCia sinh vien theo khSI So lieu d hinh 3.1 cho thay trang thai than kinh thUc vat can bSng d sinh vien khoi Y<, Ys cao hdn so vdi d sinh vien khoi Yi, Y2,, Y3 ( p>0,05). Trang thii cudng giao cam d sinh vien khoi Y4 chiem ty % thap hdn so vdi cic khoi khic (p>0,D5).
Bing 3.3.Txavm Gidi Mu'cd^
Tliap Vua Cao
Xu hudnq benh ly
hai canq thing cam xijc thudnq xuyen cua sinh vien, theo qidl Nam
n 10 193 94 3
»/b 3,3 64,3 31,3 1,0
NO' n 6 160 131 3
2,0
%
53,3 43,7 1,0
P
>0,05
<0,05
<0,05
>0,05 OR 0,4 0,6
9S<Mia 0.2-1,2 0,4-0,8
Chung hai gid) n 16 353 225 6
2,7
%
58,8 37,5 1,0 Ket qui d bang 3.3 cho thay;
- Trong cic trang thai cSng thing cim xuc thudng xuyen cd tdi 58,8% so sinh vien d miit d? lo au vuS va 37,5% d mu'c do cao. Trong vai thing gin thdi diem nghien ciJu cd 1% so sinh vien d milt do cing thing cim xuc cd xu hu'dng benh 1^.
- cd moi lien quan ding k l cjvda mut do cing thing cam xuc d nam va nu*. Ty le SV nff d miit do cang thing cim xiic vira it hdn (0R= 0,4, 95% a=0,2-l,2, p<0,05), cing thing cim ^isx. cao va xu hu'dng benh ly nhieu hdn ro ret so vdi d SV nam ( 0R= 0,6; 95% • = 0,4-0,8; p<D,05).
36
Bing 3.4. Tranq Mire dp CackhSi
SVY, (11 n=120 SVY2(2)n=120 SVY3(3)n=120 SVY.(4)n=120 SVYs(5)n=120
Y Hpc V I E T N A M rHANGIC - S6 1/2012 thai c i n q t h i n g cam xuc thudnq xuyen ciia sinh vien, theo khoi
Thap n 5 5 2 2 2
4,2
%
4,2 1,7 1,7 1,7
vera n 65 74 S7 80 77
•A 54,2 61,7 47,5 66,7 64,2
Cao n 48 40 60 37 40
40,0
%
33,3 50,0 30,8 33,3
Xu hu'dnq benh Iv n
2 1 1 1 1
»/o 1,7 0,8 0,8 0,8 0,8 0 milt d6 lo Su cao p (3-2)» , p (3-4)», p (3-5)*
So lieu d bSng 3.4 cho thay trang thai cSng thSng cam xiic thffdng xuyen ciia sinh vien e^c khoi chil yeu d mffc dp viia va cao. Mffc dp lo hu cao thudng xuyen d sinh vien n3m thff 3 (50%) cao hdn cac khdi khac cd y nghTa thdng ke vdi p<0,05, sau do la sinh vien nSm thff 1 (40%), nSm thff 2 va thff 5 (33,3%), thap nhat la nSm thff 4 (30,8%).
IV. BAN LUiDkN
Tan so mach, huyet ap tSm thu, huyet ap tam trffdng ciia sinh vien trong nghien cffu ciia chung toi deu nSm trong gidi han binh thffdng ciia thanh nien Viet Nam cung lira tuoi [2].
Khong ed sy khac bet ve lan sd mach giffa hai gidi, huyet ap tam thu, huy§t ap tam trffdng eua nam cao hdn so vdi d nff cd y nghTa thong ke vdi p<0,05 (bang 3.1). Chi so Kerdo eiia nff cao hdn nam eo y nghTa thong ke vdi p <0,05. Sd khac biet nay ed le do !yc co cd tim d nam manh hdn d nff va trffdng Iffc mach d nam cung Idn hdn d nff. So sanh ket qua nghien cffu ciia chiing toi vdi k a qua cua cac tac gia khac cho thay so lieu eua chiing toi tffdng tff vdi ket qua nghien cihj eua Pham Gia Khai, Nguyen Lin Viet [2] tren 1793 doi tuOng co dp tuoi tir 16 den 24 va nghien eu\j ciia diiing tdi tren sinh vien ba trffdng dai hpc, cao dSng tinh Thai Binh [3]. Ket qua nghien cull eua chung toi tren cac sinh vien tff nam thff nhat den nSm thff nSm cho thay trang thai than kinh thyc vat can bSng d sinh vien khdi Y4, Ys cao hdn so vdi d sinh vien eae khoi Yi, Y2,, Y3 (vdi p>0,05). Trang thai cffdng giao cam d sinh vien giam dan txi'n&m thff nhat den nSm thff 5. Trang thai cffdng giao cam d sinh vien khoi Y4 chiem ty le thap hdn so v<S cac khoi khac. Trang thai cang thang cam xuc thudng xuyen ciia sinh vien cac khoi chil yeu d mffc do viia va cao (bang 3.4).
Mffc dp lo au cao thudng xuyen d sinh vien nam thff nhat, nam thff 2, nSm thff 3, nSm thff 4 va nam thff 5 la 40%; 33,3%; 50,0%; 30,8%;
33,3%. I^ffc dp cSng thSng cao ciia sinh vien khoi Y3 cao hOn cac khdi khac ed y nghTa thong ke vdi (p<0,05), thap nhat 1^ khdi Y4. Dieu nay cd le do sinh vien phan Idn song xa nha vdi nhieu vat Vei, lo toan, thay doi phffdng phap hoc, phai thieh nghl vdi moi trffdng xa hpi mdi, mdi quan he ban be, ky vpng ciia cha me va cang thSng ve tai chinh la nhffng nguyen nhan gdp phan gay e3ng thSng d sinh vien, dac biet ia sinh vien nhffng n3m dau [1]. Sinh vien khoi Y3 bat dau di lam sang, tiep xuc vdi mot ITnh vffc hoan toan mdi dong thdi eo nhieu mon hpc co dp kho cao, ben canh nhffng mon thi test eon nhieu mon thi Viet, doi hoi hp phai cd kien thffc toan dien, do do cffdng dp cung nhff tan so kich thi'ch cang thang tSng len, dat them ganh nang gay cang thSng thffdng xuyen hdn doi vdi hp. Sinh vien khoi Y4 cd trang thai cffdng giao cam va cang thang thffdng xuyen thap nhat. Bleu dd chffng td sinh vien khoi Y4 ft bj cang thang nhat, cd le d hp da cd sy trai nghiem qua cac ky thi cung nhff viec hpc ly thuyet, thffc hanh d cac labo va di lam sang d eae benh vien, do dd d ho da cd sff thich nghi, dn djnh ve the chat cung nhff ve tam - sinh ly. Sinh vien khoi Ys lai co nhihig lo toan mdi, chuan bj budc sang nam cudi, tot nghiep ra trffdng vdi nhieu dy djnh ve viec hoc tiep hay dinh hudng eho lam viec trong tffdng lai nen mffc dp bien dpng cac chi so khong dn djnh nhff d sinh vien khoi Y4. Nhff vay sff tffhg trai cua sinh vien cac n3m cuoi vdi cang thang ve hpc tap va sinh hoat da giup cho cac em cd ban linh vffng vang hdn de ddi phd vdi stress. Dieu nay eung phu hdp vdi cac nghien cffu gan day eho rang Wnh nghidm hpc tap la mot trong nhffng yeu to qui djnh kha ning thi'ch utig eua cd the doi vdi stress^ KS qua nghien cifu eiia chiing toi tffdng ty ket qua ciia Jadoon tren 815 sinh vien y d Multen cung cho thay ty le cang thang cua sinh vien nam thff nhat, nam thff 2, nam thff 3, nam thff tff va nam cuoi ciing la 45,85%; 52,58%, 47,14%; 28,75%
Y HQC VigT NAIM THANS 10 • SO" 1/2012 v i 45,10%. Theo Shah cic yiu td gay cing
thing tren sinh vien Y hay g$p theo thir ty" l i d$
dii tal lieu khoa hipc (81%), hpc t$p qui t i l (76%), canh tranh trong thi cir (67%), c?nh tranh trong qui trinh hpc tap (46%). Ty I? sinh viln y cd mifc dp cing thing cao trong nghlin cihj ciia chiing tdi cao hdn so vdl nghlin cuU cua L^i ThS Luyin ve bilu hl$n stress trin sinh vien tnjdng Oai h<;x: SU pham cho thiy t^ 1$ rit cing thing chlim 10,8% v i cing thing chlem 49,8%.
Oieu niy chutig td sinh vHn Y chju nhieu i p l i ^ hdn sinh viln cic trudng khic.
Nghiin cut! ciia chung tdi theo gidl cho thiy ty l | cudng giao cim, mu'c dp cing thing cim xuc cao d sinh viln nff cao hdn so vdi d sinh viln nam. Ket qui nghlin cutj thu du^c d bing 3.2 cho thiy tr^ng thii can bing than kinh thi/c v^t chiem ty l | cao nhit d c i hai gidl (53,5%). So sinh trang thii than kinh thu'c v i t giua hai gidl thay ro trang thii cin bing d sinh viln nam (57%) chiem ti l | cao hdn so vdl d sinh viln nff, (50%), vdi p>0,05, cdn trang thii cu'dng giao cim d sinh vien nff (47%) lai cao hdn so vdl d sinh viln nam (37%), vdi p <0,05. Kit qui nghiin cull nay cung phii hdp vdi ket qua ciia Chung tdi thu du'dc d sinh viln ba trffdng d^l hpc, cao ding tinh Thii Binh [3], cho thay da so sinh viln cd trang thii than kinh thffc vat can bang (51,2%), trong dd d nam cd trang thii can bang cao hdn so vdi d nff, cdn d nff cd trang thai cffdng giao cim hdn so vdl d nam. So sanh giula cic tru'dng thi trang thii cffdng giao cim d sinh viln nff cua trffdng dai hpc Y cao hdn so vdi d sinh viln trffdng Cao ding Sff pham (p<0,05).
Nhieu nghiin cuU cung cho thay sinh viln Y phii trii nghiem mpt so Iffdng dang bao dpng liin quan den cing thing [5],[6],[1]. Bang 3.3 cho thay cd moi llln quan ding ke giuS mut dp cing thing cam xuc d nam va nff. Ty 1^ sinh vien nff d mffc dp ting thing cam xiic vua it hdn {0R= 0,4, 95% a=0,2-l,2, p<0,05), cing thing cam xiic cao nhieu hdn ro ret so vdi d SV nam (0R= 0,6; 95% a
= 0,4- 0,8; p<0,05). Cic kit qui tren chuTig td tr^ng thii lo au cao d nff sinh viln. De glil thfch dieu niy cac nha khoa hpc cho ring chfnh cic homion ddng mpt vai trd nhat djnh trong viec phit sinh sff khac biet ve gidi trong phin ffiig cang thing tam - than kinh. Theo Jiongjiong Wang [7] trong trang thai cing thang d nam gidi, vd nao trffdc trin phai (dieu hda nhutig cim xiic am tfnh) hoat dpng nhieu hdn, trong khi dd vd nao hoc mit - trin trai (cd vai trd ngin chin)
it bj kfch thfch hdn. OlSu niy llln quan viil Cortisol, mpt io^i hormon stress. Ngffdt lai, cing thing d phg nff chii yiu kfch hoat h$ limbic cOa nio bd, ho^t dpng d$c l$p vdl nSng d$ Cortisol, Ngoii ra, phin ffng ciia nio bd d nff kio dii Iiu hdn sau thf nghl|m. Nhff v$y, cic phin iitig ciia nao bd ddi vdl stress cua nam v i nff l i khac nhau v i stress xuc cim ciia nff da glil thi'ch tal sao hp thudng bj trim cim v i cing thing hdn iS nam. M$t khic d l glal thfch sff khic nhau vS cich glil quylt, doi m|t vdi cing thing d nam va nff, cic nhi khoa hpc cdn cho ring d nam gidi, Iffdng oxytocin (lo^l ndi tilt to khing stress) thffdng sin sinh ft lidn so vdl d nff gidl do bj ngi tilt to sinh dgc nam testosterone lan i t Do dd, phii m?nh cd xu hffdng tff ddi m?t vdi stress va khdng thfch chia sd vdf ngffdi khic.
V. KI'T LUiiN
- 0 sinh viln Dai hpc Y Thii binh, tr^ng thai than kinh thffc v^t cffdng giao cam d sinh vien glim dan tff nim thff nhat din nim thff 5. Trang thii cffdng giao cim d sinh viln khdi Y4 chiem ty l | thap hdn so vdl cac khdi khic. Ty 1^ tr^ng thai thin kinh thffc v$t cudng giao cam d sinh vien nff (47%) cao hdn so vdi d sinh viln nam (37%), vdl p<0,a5.
- Sinh viln cd bleu hi|n cua tr^ng thii cing thing than kinh cim xiic thuOng xuyin d milc vira la 58,8%, d mut cao la 37,5%. Miit dJ k) au cao thudng xuyen d sinh vien nim thff nh^, nim thff 2, nim thff 3, nim thff 4 va nim thi^ 5 li 40%; 33,3%; 50,0%; 30,8%; 33,3%. Sinh vien khdi Y] cd ty l | cing thing cim xiic cao nhSu hdn sinh viln cac khoi khac (p<0,05).Ty le sinh vien nff cd mffc dp cing thing cam xiic cao va xu hffdng benh ly nhieu hdn so vdl d sinh vien nam (OR=0,6; 95% a=0,4-0,8; p<0,05).
TAI U|U THAM KHAO
1. Phan Vin D u y ^ L« Nam T i i (1996),*Mgt sf vin de Chung ve phudng phip lu|n trong nghl&l cOU cic chi tliu sinh hpc' KS qui budc ^u nghien cdu mdt sff chi diu sinh hpc ngi0 Vl^
Nam, Nxb Y hgc. Hi N?!, Ir. 13 -18.
2. Ph^m Gia Khil, Nguyin U n Vift (2003),
"T^n so Sm v i huySt ap ddng m?ch nguSn ISn Vl$ Nam binh thffdng th$p k^ 90', Oc ga ti sinh hpc ngudi Viet Nam binh Uiudng ttiip Ity 90 - die 1^ XX, Nxb y hpc Ha NOI, tr. 122 -123.
3. Nguyin Thj Hien, Vuung Th| Hda, 'TtSn eSng Dong (2011), "Nghlin cffu mpt s5 dii»
38
Y HQC VigT NAM T H A N S 10 • S 6 ' 1/2012 m?ch, huyet ap ciia sinh vien tuoi 20-22 6 3
trudng Cao d i n g va Oai hoc tinh Thai Binh", T?p chiSinh iyhgc Viet Nam, i s (3), tr. 29-35.
l4i The Luy#n (2010), Bi&i hien stress tren sinh vidn budng BaihgcSUpham i^diu$t ThinhphSHa Chfi^inh, Luin vin thac sy Tam 19 hgc.
AI-AyadhI Ly. ( 2 0 0 5 ) , "Neurohormonal changes in medical students during academic stress", Ann Saudi Med, 25 (1), pp. 36-40.
6. Jadoon N.A. (2010), "Anxiety and depression among medical stusents: across - sectional study", J. Pair, tried. Assoc, 60 (8), pp. 699-702.
7. Jlongjiong Wang et al. (2012), "Gender difference in neural response to psychological stress", tMotd Journals of medical research.
Social Cognitive and Affective Neurosd, 2 (3), pp. 227-239.
NGHIEN Ciiu im DUNG KY THUAT PCR PHAT HIEN MOT Sd' MAM BENH GAY NHliivi KHUAN HUYET
IF.
Le HQli Song', Ngd TSit Trung* va Phan Quoc H o a n "
T6MTAT
Mgc tieu: Xay duYig guy trinh chan doan nhanh mgt so mam benh gay nhiem khuan huyet bSng PCR.
V$t ii^u & Phu'dng phap: 07 chung vi sinh v^t: C.
albicans, P. aeruginosa, S. aureus, A. baumannii, E.
Coll, S. Pneumonia va K. pneumonia du'dc phan l|ip tu"
Khoa vl sinh vat- Benh vien TU" QD 108. Cac cSp moi du^c thiet ke dSc hieu cho m5i loai khong bSt cheo vdi nhau va khong bSt c|p vdi genomics DNA ngu'di. Dp dSc hieu duWc kiem iTinh bSng giai trinh tiT gene. Do nliay cua phutfng phap du'dc danh gia bSng each pha li^ng nong do vi sinh vat tu' 10*:10^:10^1CP:10^:10':10" CRJ/mi. Ket qua: Da toi IAJ d u ^ dieu kien PCR ddn moi de phat hien 7 mam benh: C. albicans, P. aeruginosa, S. aureus, A.
tiaumannii, E. Ojii, S. f^eumonia va K. pneumonia. Oo nhay cua phu'dng phap la 1 CFU/ml, rieng d6i vdi S.
Prieumonia la 100 CFU/ml. ^ dSc hieu la 100%. K€t lu$n: Ky thuat PCR phat hien 7 mam benh ke tren da du'dc xay du^g thanh cong vdi dp nhay la 1 CFU/mi, dd'd3chieu'lalOO%.
SUMMARY
Application of Polymerase Chain Reaction for diagnosis of pathogens caused sepsis Aims: To establish a quick protocol, which can work complementarily to conventional - microbial - blood - culture approach. Material and methods:
Colonies of Eschen'diia coii, Klebsiella pneumonia, i^udomonas aeruginosa, Acinetnbacter baumannii, Stiphybcoccus aureus, Sdeptococcus pneumonia, and Candida aibk^ns were isolated at the Department of Microbiology used as positive control to monitor the success of individual test. Primer pairs are designed in 'idioa Sinh hoc phan djt, Benh vien WQD108;
"Khoa Visin'h vat, Benh vien WQD 108 Phan bi^ khoa hgc: PGS.TS. Nguyin Linh Tokn
genus - specific - manner, that devoid of cross (or/and) mis-amplifying human DNA template. The spedficity of primer pair is confirmed by Sanger sequencing, primer amplifiable sensitivity was assayed using CPU dilution series. Result: Optimized conditions for PCR had been set up, that could detect 7 pathogens such as C. all^cans, P. aemginosa, S. aureus, A. baumannii, E.
Cbli, S. Pneumonia and K. pneumonia, when the pathogens' load ©<ceeds a threshold 1-100 CFU/ml, Condusion: A molecular approach fbr Identification of blood sepss related pathogens was launched with a high sensitvity and speoffcrty.
Tu' khoa: Nhiem khuan huyet, PCR da moi.
I. O A T V & N £>E^
Nhiem khuan huyet (NKH) co the gay ra bdi nhieu nguyen nhan khac nhau, tii vi khuan, ki sinh trung va nam...
Cay mau hien <Jang du'dc cho la tieu chuan vang de xac dmh mam benh trong NKH (2,3).
Tuy nhien, viec lay mot lu'dng mau Idn d cac benh nhi sd sinh la mot viec rat kho khan, quy trinh thifc hien thu'dng keo dai tCr 48-72 gid mdi CO ket qua sd bp. Oong thdi nghien CLTU cho thay khoang 7 5 % benh nhan khong du'dc chan doan nguyen nhSn bSng cay mau (4). Vi vay, viec chan doan NKH hien nay chu yeu la diTa vao cac tri^u chLfng lam sang. Va nhu" vay thu'dng benh khong du'dc phat hien sdm, do do rat nguy hiem cho tinii mang benh nhan, dac biet la doi vdi tre nhd va ngu'di cao tuoi.
Viec phat hien DNA cua vi khuan trong mau
