Autonomic reactivity and clinical severity in children with sickle cell disease
Autonomic reactivity and clinical severity in children with sickle cell disease
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DOI：
10.1007/s10286-005-0300-9
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发表时间：
2005-12-01
影响因子：
5.8
通讯作者：
Boyce, WT
中科院分区：
文献类型：
--
作者：
Pearson, SR;Alkon, A;Boyce, WT
自主神经系统反应性的个体差异与身心健康结果有关，但很少在患有慢性病的儿童中进行研究。这项研究的目的是检验患有纯合子镰状细胞病的儿童的自主神经反应性、临床严重性、家庭应激源和精神健康症状之间的关系。19名患有纯合子镰状细胞病的儿童参加了一项横断面研究，包括父母完成的测量、病历审查和基于实验室的自主神经系统对社会、认知、身体和情感挑战的反应。自主神经反应性与临床严重程度和外化行为症状显著相关。与休息时相比，挑战时副交感神经退缩程度更高的儿童有更严重的疾病(r=-0.45，p<；0.05)；与休息时相比，挑战时更大的交感神经激活与更多的外化行为症状相关(r=0.44，p<；0.05)。与经历较少家庭压力源的儿童相比，经历主要家庭压力源的儿童有内化行为症状，但在自主神经反应性或临床严重性方面没有差异。自主神经反应性的个体差异可能为观察到的镰状细胞疾病儿童疼痛发作、其他身体并发症和行为症状的差异提供了一个新的、生物学上可信的解释。
Individual differences in autonomic nervous system reactivity have been studied in relation to physical and mental health outcomes, but rarely among children with chronic disease. The purpose of this study was to examine the associations among autonomic reactivity, clinical severity, family stressors, and mental health symptoms in children with homozygous sickle cell disease. Nineteen children with homozygous sickle cell disease participated in a cross-sectional study involving parent-completed measures, medical record reviews and laboratory-based measures of autonomic nervous system responses to social, cognitive, physical and emotional challenges. Autonomic reactivity was significantly associated with both clinical severity and externalizing behavior symptoms. Children with greater parasympathetic withdrawal during challenges compared to rest had significantly more severe disease (r = -0.45, p < 0.05); greater sympathetic activation during challenges compared to rest was associated with more externalizing behavior symptoms (r = 0.44, p < 0.05). Children experiencing major family stressors had internalizing behavior symptoms but no difference in autonomic reactivity or clinical severity compared to children experiencing fewer family stressors. Individual differences in autonomic reactivity may offer a new, biologically plausible account for observed variation in painful episodes, other physical complications and behavioral symptoms among children with sickle cell disease.