RELEVANCE OF MAJOR STRESS EVENTS AS AN INDICATOR OF DISEASE-ACTIVITY PREVALENCE IN INFLAMMATORY BOWEL-DISEASE

RELEVANCE OF MAJOR STRESS EVENTS AS AN INDICATOR OF DISEASE-ACTIVITY PREVALENCE IN INFLAMMATORY BOWEL-DISEASE
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DOI:
10.1080/08964289.1991.9937553
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发表时间:
1991-09-01
影响因子:
2.3
通讯作者:
GRAHAM, S
GRAHAM, S
中科院分区:
医学3区
文献类型:
--
作者:
DUFFY, LC;ZIELEZNY, MA;GRAHAM, S

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心理压力对炎症性肠病(IBD)复发的影响尚不清楚。 为什么一些溃疡性结肠炎(UC)或克罗恩病(CD)患者有无情的复发,而其他IBD患者经历长时间的静止期疾病仍然是一个谜。 作者检查了IBD临床发作中暴露于主要应激事件的风险。 他们在一项前瞻性研究中对124人进行了为期6个月的行为和生物学特征监测。 与未暴露受试者相比,暴露于压力的受试者表现出疾病临床发作的风险增加(RR = 2.6,95% CI:1.3-4.9)。 健康相关压力领域的升高效应指标最高(RR = 3.8,95%CI:1.5-9.9)。 在多元回归分析中,主要的压力事件仍然是疾病活动的最重要的指标,在存在的协变量考虑。 只有7%的疾病活动的变化是唯一归因于压力。 基线活动是研究样本中随后疾病活动的另一个显著指标。 综合考虑所有变量,可解释52%的观察到的方差,并涉及在监测疾病复发方面具有潜在临床重要性的因素。
The impact of psychological stress in recurrence of inflammatory bowel disease (IBD) is unclear. Why some patients with ulcerative colitis (UC) or Crohn's disease (CD) have unrelenting relapses whereas other IBD patients experience long periods of quiescent disease remains an enigma. The authors examined the risk of exposure to major stress events in clinical episodes of IBD. They followed up on 124 persons in a prospective study that monitored behavioral and biological characteristics for a period of 6 months. Stress-exposed subjects demonstrated increased risk of clinical episodes of disease when compared with unexposed subjects (RR = 2.6, 95% CI: 1.3-4.9). Elevated effect measures were highest for the domain of health-related stress (RR = 3.8, 95% CI: 1.5-9.9). In the multiple regression analysis, major stress events remained the most significant indicator of disease activity in the presence of the covariables considered. Only 7% of the variation in disease activity was uniquely attributed to stress. Baseline activity was the other notable indicator of subsequent disease activity in the study sample. All variables considered together explained 52% of the variance observed and implicated factors of potential clinical importance in monitoring recurrence of the disease.