The measurement and the evaluation of chromogranin A in saliva as an objective index of the mental stress in psychosomatic disease

目的：一般认为，外界应激因素和对应激的敏感性差异对心身疾病的发生和发展有很大影响。在这方面，为了定量地估计对压力的心身反应，我们测量了唾液中嗜铬粒蛋白A的浓度。方法：要求14名正常志愿者保持30min的休息状态，然后进行3min的心理应激。分别在应激前、应激中、应激后3个时间点测定唾液中嗜铬粒细胞A的浓度。结果：应激时唾液嗜铬粒蛋白A浓度(0.80±0.19pmol/ml)较应激前(0.32±0.08pmol/ml)显著升高(P<0.05)。另一方面，对来院就诊的患者进行嗜铬粒素A浓度测定。抑郁组(1.02±0.93pmol/ml)、惊恐障碍组(1.56±1.78pmol/ml)、白大衣高血压组(8.97±6.50pmol/ml)均显著高于正常对照组(0.32±0.28pmol/ml)。结论：唾液嗜铬粒蛋白A浓度随应激负荷的增加呈一过性升高，可作为心身疾病患者的一项较好的定量指标。

Objective : It is generally thought that the factor of the external stress and the difference of sensitivity to the stress influence greatly on the occurrence and the progress in psychosomatic disease. In this regards, to estimate psychosomatic response quantitatively to the stress, we measured the concentration of chromogranin A in saliva. Methods : The 14 normal volunteers were requested to keep the rest condition for 30 minutes, then they received mental stress for 3 minutes. We measured the concentration of chromogranin A in saliva at 3 time points before, during and after the stress. Results : When-the stress was loaded, the concentration of chromogranin A in saliva (0.80±0.19 pmol/ml) increased significantly (p<0.05) compared with the concentration before the stress (0.32±0.08 pmol/ml). On the other hand, the concentrations of chromogranin A of outpatients who visited our hospital were measured. The concentrations of patients with depression (1.02±0.93 pmol/ml), those with panic disorder (1.56±1.78 pmol/ml), and those with white coat hypertension (8.97±6.50 pmol/ml), were all higher significantly than that of the normal volunteers (0.32±0.28 pmol/ml). Conclusions : These data suggested that the concentration of the chromogranin A in saliva increased transiently by the burden of the stress, and it might be a good quantitative index of the patients with psychosomatic disease.