Stress and exacerbation in ulcerative colitis:: A prospective study of patients enrolled in remission
Stress and exacerbation in ulcerative colitis:: A prospective study of patients enrolled in remission
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DOI：
10.1111/j.1572-0241.2000.02012.x
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发表时间：
2000-05-01
影响因子：
9.8
通讯作者：
Marcheggiano, A
中科院分区：
文献类型：
--
作者：
Levenstein, S;Prantera, C;Marcheggiano, A
目的：我们试图确定是否心理社会因素影响溃疡性结肠炎的过程中，假设高感知的压力与非活动性疾病的患者将增加随后acceleration.METHODS的风险：62例已知的溃疡性结肠炎患者被纳入一个前瞻性队列研究，而在临床缓解。他们的感知压力，抑郁症状，和紧张的生活事件进行了跟踪，沿着潜在的混杂因素，长达45个月;恶化状态监测长达68 months.RESULTS：27例患者谁经历了恶化与那些谁保持在缓解。长期（过去2年）基线感知压力问卷得分在上三分位数显著增加急性加重的精算风险（风险比= 2.8，95%置信区间1.1-7.2）。在任何给定的研究访视中，高长期压力使未来8个月内恶化的风险增加两倍（三个三分位数的风险分别为8.3%、16.7%和26.2%，p = 0.02）。较短的睡眠时间、较短的缓解期、组织学活动以及使用非甾体类抗抑郁药、抗生素或口服避孕药也会增加加重的中期和/或长期风险，但调整这些变量并不能消除与压力的相关性。急性加重与紧张的生活事件，抑郁症状，短期（过去一个月）感知压力，吸烟，疾病的程度或持续时间，或严重程度最近course.Conclusions：短期压力不会引发溃疡性结肠炎的恶化，但长期感知压力增加了数月至数年期间恶化的风险。(C)2000年，我细胞，胃肠病学。
OBJECTIVE: We sought to determine whether psychosocial factors influence the course of ulcerative colitis, hypothesizing that high perceived stress among patients with inactive disease will increase the risk of subsequent exacerbation.METHODS: Sixty-two patients with known ulcerative colitis were enrolled into a prospective cohort study while in clinical remission. Their perceived stress, depressive symptoms, and stressful life events were followed, along with potential confounders, for up to 45 months; exacerbation status was monitored for up to 68 months.RESULTS: The 27 patients who experienced an exacerbation were compared with those who remained in remission. Having a score in the upper tertile on the long-term (past 2 yr) baseline Perceived Stress Questionnaire significantly increased the actuarial risk of exacerbation (hazards ratio = 2.8, 95% confidence interval 1.1-7.2). At any given study visit, high long-term stress tripled the risk of exacerbation during the next 8 months (risk for the three tertiles, 8.3%, 16.7%, and 26.2%, p = 0.02). Shorter sleep time, briefer remission, histological activity, and use of nonsteroidal antiinflammatory drugs, antibiotics, or oral contraceptives also increased the medium- and/or long-term risk of exacerbation, but adjustment for these variables did not eliminate the associations with stress. Exacerbation was not associated with stressful life events, depressive symptoms, short-term (past month) perceived stress, smoking, disease extent or duration, or severity of recent course.CONCLUSIONS: Short-term stress does not trigger exacerbation in ulcerative colitis, but long-term perceived stress increases the risk of exacerbation over a period of months to years. (C) 2000 by Am. Cell, of Gastroenterology.