小儿创伤后应激障碍患者的日间唾液皮质醇水平
Diurnal salivary cortisol in pediatric posttraumatic stress disorder.
作者信息
Carrion Victor G, Weems Carl F, Ray Rebecca D, Glaser Bronwyn, Hessl David, Reiss Allan L
机构信息
Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94305-5719, USA.
出版信息
Biol Psychiatry. 2002 Apr 1;51(7):575-82. doi: 10.1016/s0006-3223(01)01310-5.
BACKGROUND
The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). Additional information on basal cortisol levels in children exposed to trauma and experiencing PTSD symptoms may contribute to the understanding of the role of this axis in PTSD.
METHODS
Fifty-one children (30 boys and 21 girls, mean age 10.7 years) with a history of exposure to trauma and PTSD symptoms were compared with 31 age- and gender-matched healthy control subjects. Salivary cortisol was obtained from participants during home measurements and was collected four times a day (prebreakfast, prelunch, predinner, and prebed) for up to 3 consecutive days.
RESULTS
The clinical group demonstrated significantly elevated cortisol levels when compared with the control group. In addition, exploratory analyses revealed that girls with PTSD symptoms had significantly elevated cortisol levels when compared with boys with PTSD symptoms.
CONCLUSIONS
The physiologic response of children with history of trauma and with PTSD symptoms may be characterized by heightened adrenal activity.
背景
下丘脑 - 垂体 - 肾上腺（HPA）轴与创伤后应激障碍（PTSD）的病理生理学有关。关于遭受创伤并出现PTSD症状的儿童的基础皮质醇水平的更多信息，可能有助于理解该轴在PTSD中的作用。
方法
将51名有创伤暴露史且有PTSD症状的儿童（30名男孩和21名女孩，平均年龄10.7岁）与31名年龄和性别匹配的健康对照受试者进行比较。在家庭测量期间从参与者处获取唾液皮质醇，连续3天每天收集4次（早餐前、午餐前、晚餐前和睡前）。
结果
与对照组相比，临床组的皮质醇水平显著升高。此外，探索性分析显示，有PTSD症状的女孩与有PTSD症状的男孩相比，皮质醇水平显著升高。
结论
有创伤史且有PTSD症状的儿童的生理反应可能表现为肾上腺活动增强。
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