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

目的：探讨系统性红斑狼疮（SLE）患者应激状态下丘脑-垂体-肾上腺（HPA）轴的功能紊乱。对30例系统性红斑狼疮（SLE）患者和38例健康志愿者进行了心算应激试验前后血清应激相关激素水平的测定，并进行了一致感（SOC）、近期应激经历和生活质量（QOL）的基础问卷调查。SLE患者的近期应激经历和心理生活质量下降，而SOC评分与对照组相比差异无统计学意义。基础皮质醇和去甲肾上腺素水平较高的患者。与对照组应激后皮质醇和β-内啡肽水平显著升高相反，两组患者应激前后皮质醇和β-内啡肽水平无显著性差异，提示患者存在正常应激反应系统的缺陷。提示SLE患者可能存在应激-适应系统的功能障碍。

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.