张北地震后应激障碍患者神经内分泌和细胞因子的研究
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摘要
目的研究应激障碍患者血浆皮质醇、生长激素、泌乳素和白细胞介素(IL)2,6,8与正常个体的差异。方法于河北省张北尚义发生里氏62级地震后3个月,在当地选取因地震导致的创伤后应激障碍(PTSD)患者34例(PTSD组),未达到PTSD诊断标准且不符合其他精神障碍的受应激个体30例(非PTSD受应激组),未受应激者34名(对照组),进行血浆皮质醇、生长激素、泌乳素和白细胞介素(IL)2,6,8的检测。血浆皮质醇、生长激素、泌乳素、IL2检测采用放射免疫法;IL6和IL8检测采用酶联免疫法。结果PTSD组患者和非PTSD受应激组的血浆皮质醇浓度均明显高于对照组,差异有统计学意义(P=0013,P=0006);血浆IL2浓度均明显低于对照组,差异均有统计学意义(P=0000,P=0000)。三组间泌乳素及IL6的差异无统计学意义(P=0389,P=0363)。PTSD组的生长激素浓度与非PTSD受应激组(P=0099)及对照组(P=0511)的差异无统计学意义。非PTSD受应激组的生长激素浓度明显高于对照组(P=0014)。PTSD组患者IL8浓度明显高于非PTSD受应激组(P=0021),而与对照组的差异无统计学意义(P=0078)。非PTSD受应激组IL8浓度明显低于对照组(P=0000)。结论PTSD患者的神经内分泌和免疫系统有异常改变。
Objective To study plasma cortisol, growth hormone, prolactin and interleukin concentration changes in patients with post-traumatic stress disorder (PTSD) and stress disorders.Methods An earthquake took place in Zhang Bei and Shang Yi, Hebei Province in January 10~th 1998. Three months later, we used radio-immunity technique to test plasma cortisol, growth hormone and prolactin and Interleukine-2 (IL-2) concentrations, and Elisa technique to test plasma Interleukine-6 (IL-6), Interleukine-8 (IL-8) concentrations in 34 trauma survivors with PTSD (diagnosed according to Diagnostic and Statistical Mannal of Mental Disorders IV criteria), 30 trauma survivors without PTSD and 34 normal controls in Zhang Bei, Shang Yi.Results Plasma concentrations in survivors with PTSD and those without PTSD were all significantly higher than that in normal controls (P=0.013, P=0.006). Plasma IL-2 concentrations in trauma survivors with PTSD and trauma survivors without PTSD were all significantly lower in comparison to normal controls (P=0.000,P=0.000). Plasma prolactin hormone and IL-6 concentrations were not significantly different among the three groups (P=0.389,P=0.363). Plasma growth hormone concentration in trauma survivors with PTSD was not different from that in trauma survivors without PTSD (P=0.099), and normal control (P=0.014), but significantly higher in trauma survivors without PTSD than in normal controls (P=0.014). Plasma IL-8 concentration in trauma survivors with PTSD was significantly higher than in trauma survivors without PTSD (P=0.021), but not different from normal control (P=0.078), and significantly lower in trauma survivors without PTSD than in normal control (P=0.000).Conclusion It is indicted that the neuroendocrine and immunology systems in PTSD and stress disorder are abnormally changed.
Objective To study plasma cortisol, growth hormone, prolactin and interleukin concentration changes in patients with post-traumatic stress disorder (PTSD) and stress disorders.Methods An earthquake took place in Zhang Bei and Shang Yi, Hebei Province in January 10~th 1998. Three months later, we used radio-immunity technique to test plasma cortisol, growth hormone and prolactin and Interleukine-2 (IL-2) concentrations, and Elisa technique to test plasma Interleukine-6 (IL-6), Interleukine-8 (IL-8) concentrations in 34 trauma survivors with PTSD (diagnosed according to Diagnostic and Statistical Mannal of Mental Disorders IV criteria), 30 trauma survivors without PTSD and 34 normal controls in Zhang Bei, Shang Yi.Results Plasma concentrations in survivors with PTSD and those without PTSD were all significantly higher than that in normal controls (P=0.013, P=0.006). Plasma IL-2 concentrations in trauma survivors with PTSD and trauma survivors without PTSD were all significantly lower in comparison to normal controls (P=0.000,P=0.000). Plasma prolactin hormone and IL-6 concentrations were not significantly different among the three groups (P=0.389,P=0.363). Plasma growth hormone concentration in trauma survivors with PTSD was not different from that in trauma survivors without PTSD (P=0.099), and normal control (P=0.014), but significantly higher in trauma survivors without PTSD than in normal controls (P=0.014). Plasma IL-8 concentration in trauma survivors with PTSD was significantly higher than in trauma survivors without PTSD (P=0.021), but not different from normal control (P=0.078), and significantly lower in trauma survivors without PTSD than in normal control (P=0.000).Conclusion It is indicted that the neuroendocrine and immunology systems in PTSD and stress disorder are abnormally changed.
引文
1张向阳,周东丰,沈渔邨,等精神分裂症神经内分泌激发试验研究临床精神医学杂志,1999,9:321323
2张向阳,周东丰,沈渔邨,等精神分裂症白细胞介素2、6、8与精神病理的关系中国神经精神疾病杂志,1999,6:346348
3SelyeH ThestressoflifeNewYork:McGrawHillBookCompany,195697127
4MillsPJ,ZieglerMG,PattersonT, etalPlasmacatecholamineandlymphocytebeta2adrenergicreceptoralterationsinelderlyAlzheimercaregiversunderstressPsychosomMed,1997,59:251256
5RivierCL,PlotskyPM Mediationbycorticotropinreleasingfactor(CRF)ofadenohypophysialhormonesecretionAnnuRevPhysiol,1986,48:475494
6MunckA,GuyrePM,HolbrookNJ PhysiologicalfunctionsofglucocorticoidsinstressandtheirrelationtopharmacologicalactionsEndocrRev,1984,5:2544
7PitmanRK,OrrSP Twenty fourhoururinarycortisolandcatecholamineexcretionincombat relatedposttraumaticstressdisorderBiolPsychiatry,1990,27:245247
8BoscarinoJA Posttraumaticstressdisorder, exposuretocombat, andlowerplasmacortisolamongVietnamveterans: findingsandclinicalimplicationsJConsultClinPsychol,1996,64:191201
9YehudaR,TeicherMH,TrestmanRL, etalCortisolregulationinposttraumaticstressdisorderandmajordepression: achronobiologicalanalysisBiolPsychiatry,1996,40:7988
10SelyeH Selye′sguidetostressresearchNewYork:VanNostrandReinhold,1980295296
11DavisLL,ClarkDM,KramerGL, etalD fenfluraminechallengeinposttraumaticstressdisorderBiolPsychiatry,1999,45:928930
12KolbLC AcriticalsurveyofhypothesesregardingposttraumaticstressdisordersinhightofrecentresearchfindingJTraumaStress,1988,1:291304
13AnsseauM,VonFrenckellR,CerfontaineJL, etalBluntedresponseofgrowthhormonetoclonidineandapomorphineinendogenousdepressionBrJPsychiatry,1988,153:6571
14HansenneM,PitchotW,AnsseauM TheclonidinetestinposttraumaticstressdisorderAmJPsychiatry,1991,148:810811
15MaesM,LinAH,DelmeireL, etalElevatedseruminterleukin6(IL 6) andIL 6receptorconcentrationsinposttraumaticstressdisorderfollowingaccidentalman madetraumaticeventsBiolPsychiatry,1999,45:833839
16SluzewskaA,RybakowskiJ,BosmansE, etalIndicatorsofimmuneactivationinmajordepressionPsychiatryRes,1996,64:161167
2张向阳,周东丰,沈渔邨,等精神分裂症白细胞介素2、6、8与精神病理的关系中国神经精神疾病杂志,1999,6:346348
3SelyeH ThestressoflifeNewYork:McGrawHillBookCompany,195697127
4MillsPJ,ZieglerMG,PattersonT, etalPlasmacatecholamineandlymphocytebeta2adrenergicreceptoralterationsinelderlyAlzheimercaregiversunderstressPsychosomMed,1997,59:251256
5RivierCL,PlotskyPM Mediationbycorticotropinreleasingfactor(CRF)ofadenohypophysialhormonesecretionAnnuRevPhysiol,1986,48:475494
6MunckA,GuyrePM,HolbrookNJ PhysiologicalfunctionsofglucocorticoidsinstressandtheirrelationtopharmacologicalactionsEndocrRev,1984,5:2544
7PitmanRK,OrrSP Twenty fourhoururinarycortisolandcatecholamineexcretionincombat relatedposttraumaticstressdisorderBiolPsychiatry,1990,27:245247
8BoscarinoJA Posttraumaticstressdisorder, exposuretocombat, andlowerplasmacortisolamongVietnamveterans: findingsandclinicalimplicationsJConsultClinPsychol,1996,64:191201
9YehudaR,TeicherMH,TrestmanRL, etalCortisolregulationinposttraumaticstressdisorderandmajordepression: achronobiologicalanalysisBiolPsychiatry,1996,40:7988
10SelyeH Selye′sguidetostressresearchNewYork:VanNostrandReinhold,1980295296
11DavisLL,ClarkDM,KramerGL, etalD fenfluraminechallengeinposttraumaticstressdisorderBiolPsychiatry,1999,45:928930
12KolbLC AcriticalsurveyofhypothesesregardingposttraumaticstressdisordersinhightofrecentresearchfindingJTraumaStress,1988,1:291304
13AnsseauM,VonFrenckellR,CerfontaineJL, etalBluntedresponseofgrowthhormonetoclonidineandapomorphineinendogenousdepressionBrJPsychiatry,1988,153:6571
14HansenneM,PitchotW,AnsseauM TheclonidinetestinposttraumaticstressdisorderAmJPsychiatry,1991,148:810811
15MaesM,LinAH,DelmeireL, etalElevatedseruminterleukin6(IL 6) andIL 6receptorconcentrationsinposttraumaticstressdisorderfollowingaccidentalman madetraumaticeventsBiolPsychiatry,1999,45:833839
16SluzewskaA,RybakowskiJ,BosmansE, etalIndicatorsofimmuneactivationinmajordepressionPsychiatryRes,1996,64:161167
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