Basic study as to stress maladjustment and effect of a self-management program in patients with systemic lupus erythematosus.

阐明系统性红斑狼疮患者应激时下丘脑-垂体-肾上腺（HPA）轴作为稳态系统的任何功能障碍的证据。对30例系统性红斑狼疮（SLE）患者和38名健康志愿者进行心理计算压力测试前后血清应激相关激素水平的检测，并对一致性感（SOC）、近期应激经历和生活质量（QOL）进行基础问卷研究。SLE患者的基础生理生活质量下降，精神生活质量下降，但近期应激经历和SOC评分与对照组差异不大。患者的基础皮质醇和去甲肾上腺素水平较高。具有特点的是，与对照组的皮质醇和β-内啡肽水平在压力测试后显著升高相反，两名患者在测试前后的皮质醇和β-内啡肽水平没有显著差异，这表明患者正常的应激反应系统存在缺陷。目前的结果表明，SLE患者可能存在压力适应系统功能受损。

To clarify the evidence of any functional disturbances inhypothalamic-pituitary-adrenal (HPA) axis as a homeostatic system upon stress in patients with systemic lupus erythematosus. Various serum levels of stress-related hormones were examined before and after a mental calculation stress test, and a basal questionnaire study as to sense of coherence (SOC), recent stress experiences, and quality of life (QOL) was performed, in 30 patients with systemic lupus erythematosus (SLE), and also in 38 healthy volunteers.Basal physical QOL state decreased in the patients, and mental QOL decreased in SLE patients, but there was little difference in recent stress experiences and SOC scores between patients and controls. Basal cortisol and noradrenalin levels were higher in the patients. Characteristically, contrary to the control group whose cortisol andβ-endorphin levels increased significantly following the stress test, no significantdifferences were seen in their levels between pre- and post-test in both of the patients, suggesting a defect in normal stress-response system in patients. The present results suggest that in SLE patients there may be an impaired function in stress-adaptationsystem.