Imbalance in the Stress-Adaptation System in Patients With Inflammatory Bowel Disease
Imbalance in the Stress-Adaptation System in Patients With Inflammatory Bowel Disease
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DOI：
10.1177/1099800410388638
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发表时间：
2011-10-01
影响因子：
2.5
通讯作者：
Fujimoto, Kazuma
中科院分区：
文献类型：
--
作者：
Kuroki, Tsukasa;Ohta, Akihide;Fujimoto, Kazuma
目的：虽然炎症性肠病（IBD）被认为是一种与压力相关的疾病，但这一说法缺乏基本证据。本研究旨在探讨神经内分泌免疫系统作为IBD患者应激反应和应激应对能力的主要通路的功能，以及应激反应、应激应对能力和疾病活动性之间的关系。方法：对78例IBD患者和21名健康志愿者的压力状态和压力应对能力（自我效能感和连贯感[SOC]）进行问卷调查。在计算压力测试前后抽取血液样本，测定血清中各种与压力相关的激素和细胞因子的水平。结果：患者的自我效能感显著降低，但应激感知程度和SOC在患者与对照组之间无显著差异。皮质醇的基础水平没有差异，但促肾上腺皮质激素、β -内啡肽和白细胞介素(IL)-6的水平在患者中明显高于对照组。此外，对照组，而不是患者组，在低和高SOC亚组之间以及低和高感知压力亚组之间显示出基础皮质醇水平的显著差异。此外，仅在患者中进行计算压力测试后，IL-6水平显著升高。结论：IBD患者可能存在神经内分泌免疫系统失调，情绪紧张可能加重病情。压力管理干预可能是有用的，不仅对患者的生活质量（QOL），而且对疾病控制。
Aim: Though inflammatory bowel disease (IBD) is known as a stress-related disorder, basic evidence for this claim is lacking. The current study was performed to investigate the function of the neuroendocrine-immune system as a main pathway in stress response and stress-coping ability and the associations among stress response, stress-coping ability, and disease activity in IBD patients. Method: A questionnaire was administered to obtain information concerning stress state and stress-coping ability (self-efficacy and sense of coherence [SOC]) in 78 IBD patients and 21 healthy volunteers. Blood samples were taken for determining the serum levels of various stress-related hormones and cytokines before and after a calculation stress test. Results: Self-efficacy was significantly decreased in patients, though the degree of perceived stress and SOC did not differ between patients and controls. Basal levels of cortisol did not differ, but levels of adrenocorticotropic hormone, beta-endorphin and interleukin (IL)-6 were significantly higher in patients than in controls. In addition, the control group, but not the patient group, demonstrated significant differences in the basal cortisol levels between low and high SOC subgroups and between low and high perceived stress subgroups. Furthermore, IL-6 levels were significantly increased following the calculation stress test in patients only. Conclusion: Results indicate that IBD patients may have skewed neuroendocrine-immune systems and that emotional stress may aggravate the disease. Stress-management interventions might be useful, not only for patients' quality of life (QOL) but also for disease control.