Skarpa I, Rubesa G, Moro L, Manestar D, Petrovecki M, Rukavina D
Department of Psychiatry, Rijeka University School of Medicine, B. Branchetta 20, 51000 Rijeka, Croatia.
Croat Med J. 2001 Oct;42(5):551-5.
To define phenotypic characteristics of cytotoxic T lymphocytes (CTL) and natural killer cells (NK) in peripheral blood, frequency of somatic symptoms, and level of anxiety and depression in 25 patients clinically diagnosed with chronic post-traumatic stress disorder (PTSD).
Patients were divided into two sub-groups according to the stressor: 18 PTSD patients with the battlefield experience and 7 PTSD patients with battlefield experience who were tortured as the prisoners of war (POW) in Bosnian-Serbian camps. The control group consisted of 15 healthy volunteers matched to the patients by sex and age. We tested all patients using Becks depression inventory, Spielberger anxiety test, and somatic disturbance list, and analyzed their peripheral blood lymphocytes using flow cytometry with the double fluorescence staining of cell surface antigens (CD3, CD4, CD8, CD16, and CD56) and intracellular cytolytic molecule perforin (P), a mediator of cytolytic action at the molecular level.
All PTSD patients showed a significant level of anxiety, depression, and numerous somatic symptoms. The only significant difference between PTSD patients with and without POW experience was in the anxiety level (median, 71; range 61-79; vs median, 65; range, 49-77). PTSD patients with POW experience had significantly higher levels of CD16+ cells (median, 37%; range, 16-55%) than those without it (median, 12%; range, 5-37%). Double labeling for intracellular P antigen and cell surface antigens showed the highest levels of CD16+P+ (median, 33%; range, 15-40%; vs median, 10%; range, 3-29%) and CD56+P+ (median, 21%; range, 11-40%; vs median 8%; range, 1-30%) cells in PTSD-POW patients.
Chronic PTSD patients who survived concentration camps show the most numerous alterations in PBL phenotype, the highest number of perforin-containing cells, and a significantly higher level of anxiety.
确定25例临床诊断为慢性创伤后应激障碍（PTSD）患者外周血中细胞毒性T淋巴细胞（CTL）和自然杀伤细胞（NK）的表型特征、躯体症状频率以及焦虑和抑郁水平。
根据应激源将患者分为两个亚组：18例有战场经历的PTSD患者和7例在波斯尼亚 - 塞尔维亚营地作为战俘遭受折磨且有战场经历的PTSD患者。对照组由15名年龄和性别与患者匹配的健康志愿者组成。我们使用贝克抑郁量表、斯皮尔伯格焦虑测试和躯体障碍清单对所有患者进行测试，并通过细胞表面抗原（CD3、CD4、CD8、CD16和CD56）和细胞内溶细胞分子穿孔素（P，分子水平溶细胞作用的介质）的双荧光染色，利用流式细胞术分析他们的外周血淋巴细胞。
所有PTSD患者均表现出显著的焦虑、抑郁水平以及众多躯体症状。有战俘经历和无战俘经历的PTSD患者之间唯一显著的差异在于焦虑水平（中位数，71；范围61 - 79；对比中位数，65；范围，49 - 77）。有战俘经历的PTSD患者的CD16 + 细胞水平（中位数，37%；范围，16 - 55%）显著高于无战俘经历的患者（中位数，12%；范围，5 - 37%）。细胞内P抗原和细胞表面抗原的双重标记显示，在有战俘经历的PTSD患者中，CD16 + P + 细胞（中位数，33%；范围，15 - 40%；对比中位数，10%；范围，3 - 29%）和CD56 + P + 细胞（中位数，21%；范围，11 - 40%；对比中位数8%；范围，1 - 30%）水平最高。
在集中营中幸存的慢性PTSD患者在外周血淋巴细胞表型变化最多，含穿孔素细胞数量最多，且焦虑水平显著更高。
