Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China.
Chin Med J (Engl). 2012 Apr;125(7):1292-6.
Over one million soldiers were treated for battle- or training-fatigue during World War II. Of all ground combat troops, 37% were discharged for psychiatric reasons due to fatigue. The neuroendocrinological and immunological systems played important roles in the work-related fatigue of military personnel. The aim of this study was to investigate the characteristics of fatigue associated with military operations, and we observed changes in the regulatory functions of the neuroendocrinological and immunological systems that may provide theoretical support for improving the combat effectiveness of armies.
A total of 240 soldiers from the Field Artillery regiment were selected as subjects. Researchers and subjects received training before participating in the study. Data of the subjects' medical histories, physical examinations, scores on a fatigue assessment scale, and assessments of pituitary-adrenal hormones (adrenal cortical hormone (ACTH), cortical hormone (F), and 24-hour urine-free cortisol (UFC)), pituitary-gonadal hormones (luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, estradiol (E2), and prolactin (PRL)), pituitary-thyroid hormones (thyroid-stimulating hormone (TSH), thyroxine (TT4), triiodothyronine (TT3), free thyroxine (FT4), and free triiodothyronine (FT3)), and cellular immune parameters (CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), B, and NK cells) were investigated before and after large-scale and high-intensity field exercises. Data were statistically analyzed with Student's t test using SPSS software (version 13.0), and P values < 0.05 were deemed to be significant.
After the high-intensity military training, the scores on the fatigue scale reflected significant increases of feeling of unpleasantness among soldiers. Additionally, the symptom checklist showed notable increases in somatization scores and significant decreases in psychoticism scores. After intensive military work, levels of plasma ACTH, F, and UFC of soldiers were decreased (P < 0.01). The level of testosterone decreased significantly after the maneuver ((23.51 ± 6.49) versus (18.89 ± 5.89) nmol/L; P < 0.001), whereas the thyroid function (TT3, FT4, and FT3) was markedly increased after the maneuver (P < 0.01). The number of CD3(+), CD4(+), CD4(+)/CD8(+) cells, and B lymphocytes were decreased (P < 0.05), and NK cells were increased (P < 0.001) after the maneuver.
Following high-intensity military operations, the psychological tolerance of soldiers was depressed. And the hypoadrenocorticism (the functional decreases of hypothalamic-pituitary-gonadal and abnormal pituitary-thyroid axis) contributed to the increased levels of fatigue. Hypoimmunity may increase the susceptibility to diseases after high-intensity military operations.
在第二次世界大战期间，有超过 100 万名士兵接受了战斗或训练疲劳的治疗。在所有地面作战部队中，由于疲劳，有 37%的士兵因精神原因而被解雇。神经内分泌和免疫系统在军事人员的与工作相关的疲劳中发挥了重要作用。本研究旨在探讨与军事行动相关的疲劳特征，并观察神经内分泌和免疫系统的调节功能变化，为提高军队战斗力提供理论支持。
共选择野战炮兵团的 240 名士兵作为研究对象。研究人员和受试者在参加研究前接受了培训。记录受试者的病史、体检、疲劳评估量表评分以及垂体肾上腺激素（促肾上腺皮质激素（ACTH）、皮质激素（F）和 24 小时尿游离皮质醇（UFC））、垂体性腺激素（黄体生成素（LH）、卵泡刺激素（FSH）、睾丸激素、雌二醇（E2）和催乳素（PRL））、垂体甲状腺激素（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）和游离三碘甲状腺原氨酸（FT3））和细胞免疫参数（CD3(+)、CD4(+)、CD8(+)、CD4(+)/CD8(+)、B 和 NK 细胞）在大规模高强度野外作业前后进行了调查。使用 SPSS 软件（版本 13.0）进行学生 t 检验的统计分析，P 值<0.05 被认为具有统计学意义。
高强度军事训练后，疲劳量表的评分反映出士兵不愉快感明显增加。此外，症状清单显示躯体化评分显著增加，精神病性评分显著降低。经过密集的军事工作后，士兵的血浆 ACTH、F 和 UFC 水平降低（P<0.01）。在演习后，睾丸激素水平显著下降（（23.51±6.49）对（18.89±5.89）nmol/L；P<0.001），而甲状腺功能（TT3、FT4 和 FT3）在演习后显著增加（P<0.01）。演习后 CD3(+)、CD4(+)、CD4(+)/CD8(+)细胞和 B 淋巴细胞数量减少（P<0.05），NK 细胞增加（P<0.001）。
高强度军事行动后，士兵的心理承受能力受到抑制。而肾上腺皮质功能减退症（下丘脑-垂体-性腺和异常垂体甲状腺轴功能下降）导致疲劳水平升高。低免疫力可能会增加高强度军事行动后患病的易感性。
