Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: Research and clinical implications
Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: Research and clinical implications
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DOI：
10.1097/00006842-199905000-00019
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发表时间：
1999-05-01
影响因子：
3.3
通讯作者：
Chang, J
中科院分区：
文献类型：
--
作者：
Boscarino, JA;Chang, J
目的：研究表明，患有创伤后应激障碍（PTSD）的个体更有可能出现疾病和其他与压力相关的精神障碍。鉴于这些发现和其他表明创伤后应激障碍受害者可能改变神经内分泌和免疫系统的研究结果，越南退伍军人患有创伤后应激障碍的白细胞和淋巴细胞计数异常高的假设得到了验证。方法:在控制智力、种族、年龄、收入、教育程度、入伍类型、越南志愿军身份、出生地区、吸烟、使用非法药物、体重指数和饮酒等因素的情况下，将目前患有部分创伤后应激障碍（N = 286）、焦虑障碍（N = 274）和抑郁障碍（N = 192）的越南“战区”男性退伍军人的白细胞和淋巴细胞状况与服役20年后没有这些障碍的越南退伍军人（N = 2190）进行比较。使用标准实验室参考范围定义异常值。还比较了调整后的平均差异。结果：双侧检验结果显示，ptsd阳性退伍军人白细胞调整数（OR = 1.83, p = 0.04）和t细胞调整数（OR = 1.82, p = 0.045）高于正常范围，白细胞调整数（p = 0.042）、淋巴细胞调整数（p = 0.01）、t细胞调整数（p = 0.008）和CD4细胞调整数（p = 0.027）高于正常范围。焦虑障碍患者淋巴细胞计数（OR = 1.68, p = 0.048）和t细胞计数（OR = 2.06, p = 0.011）高于正常范围。他们也有测试结果显示反应性延迟皮肤过敏（OR = 1.77, p = 0.006），这表明存在高度敏感的t细胞淋巴细胞。最后，抑郁老兵b细胞计数高于参考范围的可能性更小（OR = 0.55, p = 0.006）。单侧试验结果进一步表明，ptsd阳性男性的CD4和CD8 t细胞计数也异常高（p < 0.05）。结论：我们的研究结果表明，慢性，主要是与战斗相关的创伤后应激障碍与临床白细胞和总t细胞计数升高有关。除了高度敏感的t细胞淋巴细胞外，那些患有当前焦虑症的人也有一些这些异常。需要进一步的研究来具体说明这里涉及的机制，并调查与这些发现相关的健康风险。
Objectives: Research suggests that individuals with posttraumatic stress disorder (PTSD) are more likely to develop medical conditions and other stress-related psychiatric disorders. Given these findings and others suggesting that PTSD victims may have altered neuroendocrine and immune systems, the hypothesis that Vietnam veterans with PTSD have abnormally high leukocyte and lymphocyte counts was tested. Methods: The leukocyte and lymphocyte status of male Vietnam "theater" veterans with current partial posttraumatic stress (N = 286), anxiety (N = 274), and depression disorders (N = 192) were compared with those of Vietnam veterans without these disorders 20 years after military service (N = 2190), controlling for intelligence, race, age, income, education, type of enlistment, Vietnam volunteer status, region of birth, cigarette smoking, illicit drug use, body mass index, and alcohol consumption. Abnormal values were defined using standard laboratory reference ranges. Adjusted mean differences also were compared. Results: Based on the results of two-tailed tests, PTSD-positive veterans are more likely to have adjusted leukocyte (OR = 1.83, p = .04) and T-cell (OR = 1.82, p = .045) counts above the normal range and higher mean adjusted leukocyte (p = .042), lymphocyte (p = .01), T-cell (p = .008), and CD4 cell (p = .027) counts. Those with anxiety disorders have adjusted lymphocyte (OR = 1.68, p = .048) and T-cell (OR = 2.06, p = .011) counts above range. They also have test results indicating reactive delayed cutaneous hypersensitivity (OR = 1.77, p = .006), which suggests the presence of highly sensitized T-cell lymphocytes. Finally, depressed veterans are less likely to have B-cell counts above the reference range (OR = 0.55, p = .006). Results of one-tailed tests further suggest that PTSD-positive men also have abnormally high CD4 and CD8 T-cell lymphocyte counts as well (p < .05). Conclusions: Our findings suggest that chronic, primarily combat-related PTSD is associated with clinically elevated leukocyte and total T-cell counts. Those with current anxiety also have some of these abnormalities in addition to highly sensitized T-cell lymphocytes. Additional research is needed to specify the mechanisms involved here and to investigate the health risks associated with these findings.