Scanlan J M, Vitaliano P P, Ochs H, Savage M V, Borson S
Department of Psychiatry, University of Washington, Seattle 98195, USA.
Psychosom Med. 1998 Sep-Oct;60(5):644-53. doi: 10.1097/00006842-199809000-00023.
This study examined relationships of gender, psychosocial stress/distress (caregiving, hassles, depressed mood), and the relative percentage and absolute cell counts of CD4 and CD8 cells in two samples of older adults (mean age = 69.4)--spouse caregivers of persons with Alzheimer's disease (N = 78) and age- and gender-matched spouses of nondemented controls (N = 72).
Counts and percentages of CD4 and CD8 cells and psychosocial variables were assessed twice (Time 1, Time 2) over a 15- to 18-month period. Several covariates were examined in the analyses, including body mass index (BMI), medication use, alcohol use, exercise, and illness history.
Caregiver men had fewer CD4 cell counts at Times 1 and 2 than did control men (p < .05). At Times 1 and 2, both CD8 cell counts and percentages were positively associated with hassles in men (p < .05), but not in women. Although interactions of hassles and gender were present for CD8 percentages at both times, interactions and main effects were not present for CD4 percentages at either time. When the ratio of CD4 to CD8 levels was analyzed, hassles by gender interactions were present at both Times 1 and 2-hassles were negatively associated with the CD4/CD8 ratio in men (p < .05), but unrelated in women. From Time 1 to Time 2, change analyses showed that increases in hassles scores were associated with decreases in CD4 counts (p < .05), whereas increases in Hamilton Depression Scores were related to increases in both CD8 counts and percentages (p < .05).
Caregiver status, hassles, and depressed mood had cross-sectional and/or longitudinal associations with CD4 and CD8 counts, but such relationships occurred primarily in men. Moreover, absolute cell counts were more related to psychosocial factors than were percentages.
本研究考察了性别、心理社会压力/困扰（照料、日常烦扰、抑郁情绪）以及两个老年样本（平均年龄 = 69.4岁）中CD4和CD8细胞的相对百分比及绝对细胞计数之间的关系，这两个样本分别是阿尔茨海默病患者的配偶照料者（N = 78）以及年龄和性别匹配的非痴呆对照者的配偶（N = 72）。
在15至18个月的时间内对CD4和CD8细胞的计数及百分比以及心理社会变量进行了两次评估（时间1、时间2）。分析中考察了几个协变量，包括体重指数（BMI）、药物使用、酒精使用、运动和疾病史。
照料者男性在时间1和时间2时的CD4细胞计数少于对照男性（p < .05）。在时间1和时间2时，男性的CD8细胞计数和百分比均与日常烦扰呈正相关（p < .05），但女性并非如此。尽管两次测量时CD8百分比均存在日常烦扰与性别的交互作用，但两次测量时CD4百分比均不存在交互作用和主效应。当分析CD4与CD8水平的比值时，时间1和时间2时均存在日常烦扰与性别的交互作用——日常烦扰与男性的CD4/CD8比值呈负相关（p < .05），而与女性无关。从时间1到时间2，变化分析表明日常烦扰得分的增加与CD4计数的减少相关（p < .05），而汉密尔顿抑郁评分的增加与CD8计数和百分比的增加相关（p < .05）。
照料者状态、日常烦扰和抑郁情绪与CD4和CD8计数存在横断面和/或纵向关联，但这种关系主要发生在男性中。此外，绝对细胞计数比百分比与心理社会因素的关系更为密切。
