军事作业性疲劳的神经内分泌免疫机制研究

目的 观察军事作业性疲劳引起的神经-内分泌-免疫系统变化的规律,探讨军事作业疲劳的机制.方法 纳入某部野战炮兵团240人,军事作业前对所有研究对象进行病史询问、体格检查,填写疲劳评估量表,检测研究对象垂体-肾上腺血浆促肾上腺皮质激素(ACTH)、皮质激素(F)、24h尿游离皮质醇(UFC)]、垂体-性腺黄体生成素(LH)、睾酮(T)、雌二醇(E2)]、垂体-甲状腺功能血清促甲状腺激素(TSH)、甲状腺素(TT4)、三碘甲状腺原氨酸(TT3)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)]和细胞免疫指标(CD3+、CD4+、CD8+、CD4+/CD8+、B、NK),并在研究对象进行7d大规模高强度野外演习后重新进行上述项目的检测.结果 高强度军事作业后指战员不快感明显增加,强迫评分、精神病性评分降低.高强度军事作业后指战员垂体-肾上腺及垂体-性腺激素水平下降(P＜0.001),垂体-甲状腺激素水平升高(p＜0.05),机体细胞免疫及体液免疫功能降低(P＜0.001).结论 高强度军事作业时,战士的精神心理耐受性降低是易疲劳的心理因素,肾上腺皮质功能降低及下丘脑-垂体-性腺轴抑制是其病理生理基础,而机体免疫能力低下是高强度军事作业后易患疾病增加的重要原因.

Study of the neuroendocrine and immunologic mechanism of fatigue caused by military operations

Objective To evaluate the characteristics of the changes in nerve-internal secretion-immunologic system caused by fatigue due to military operations,and explore the mechanism of fatigue resulting from military operations.Methods The subjects were 240 soldiers belonging to a field artillery force.The medical history and physical examination were taken before military operations,and fatigue assessment scale was accomplished as well.The following variables were measured in all the subjects: pituitary-adrenal hormone adrenocorticotropic hormone(ACTH),cortical hormone(B),24 h urine free corticosteroid(UFC)],pituitary-gonadal hormone luteinizing hormone(LH),testosterone(T),estradiol(E2)],pituitary-thyroid hormone thyroid stimulating hormone(TSH),tetraiodothyronine(TT4),triiodothyronine(TT3),free thyroxine(FT4),and free triiodothyronine(FT3)],and the cellular immune parameters(CD3+,CD4+,CD8+,CD4+/CD8+,B,NK).After 7 d of large-scale and high-intensity field exercises,the above variables were again measured in all the subjects.Results After high-intensity military operations,the unpleasant feelings were significantly increased in the soldiers,and the forced and psychotic scores significantly decreased.In addition,the pituitary-adrenal hormone level decreased(P<0.001),the pituitary-gonadal hormone level also decreased(P<0.001),and the pituitary-thyroid hormone level increased(P<0.05).Moreover,the immune responsibility of body cells and immunological competence of body fluid decreased after high-intensity exercises(P<0.001).Conclusion The depressed psychological tolerance in soldiers is the psychological factor of fatigue after a high-intensity military operation.The hypocorticoidism and inhibition of hypothalamic-pituitary-gonadal axis are the pathophysiological basis of the fatigue caused by military operations.Hypo-immunity is an important reason for an increase of susceptibility to disease after high-intensity military operation.