Maes Michael, Bosmans Eugene, Ombelet Willem
Department of Psychiatry, University of Maastricht, Maastricht, the Netherlands.
J Clin Psychiatry. 2004 Jan;65(1):71-6. doi: 10.4088/jcp.v65n0112.
Delivery is accompanied by increases in anxiety levels that are significantly related to an activation of the inflammatory response system (IRS), as indicated by increases in the serum concentrations of interleukin-6 and the interleukin-1 receptor antagonist (IL-1RA) and increases in the activity of prolyl endopeptidase (PEP), a cytosolic endopeptidase that cleaves peptide bonds on the carboxyl side of proline in behaviorally active neuropeptides involved in anxiety. Primiparae may show an immune responsivity differing from that in multiparae. The aims of this study were to examine whether there are differences in anxiety levels, the IRS, and serum PEP values between primiparae and multiparae before and after delivery.
We administered the Spielberger State-Trait Anxiety Inventory (STAI) to and assessed serum IL-1RA and soluble CD8 (sCD8) concentrations and serum PEP activity in 48 primiparae and 48 multiparae at the end of term and 1 and 3 days after delivery. Data were gathered in 1996 and 1997.
We found that in primiparae (p =.001), but not in multiparae (p =.6), there was a significant increase in the STAI score 3 days after delivery and that primiparae had significantly higher STAI scores than multiparae 3 days after delivery (p =.01). Primiparae showed significantly higher serum IL-1RA levels than multiparae 1 (p =.003) and 3 (p =.02) days after delivery, but not before delivery. Primiparae also had lower serum sCD8 and higher serum PEP activity than multiparae before and after delivery.
The results suggest that primiparae suffer greater anxiety and have a different neuroimmune responsivity than multiparae and that the increased anxiety levels in primiparae may be related to changes in the IRS and serum PEP activity.
分娩伴随着焦虑水平的升高，这与炎症反应系统（IRS）的激活显著相关，血清白细胞介素-6和白细胞介素-1受体拮抗剂（IL-1RA）浓度的升高以及脯氨酰内肽酶（PEP）活性的增加表明了这一点。PEP是一种胞质内肽酶，可切割参与焦虑的行为活性神经肽中脯氨酸羧基侧的肽键。初产妇可能表现出与经产妇不同的免疫反应性。本研究的目的是检查初产妇和经产妇在分娩前后的焦虑水平、IRS和血清PEP值是否存在差异。
我们对48名初产妇和48名经产妇在足月时、分娩后1天和3天进行了斯皮尔伯格状态-特质焦虑量表（STAI）测试，并评估了血清IL-1RA和可溶性CD8（sCD8）浓度以及血清PEP活性。数据收集于1996年和1997年。
我们发现，初产妇在分娩后3天STAI评分显著增加（p = 0.001），而经产妇则无显著变化（p = 0.6），且初产妇在分娩后3天的STAI评分显著高于经产妇（p = 0.01）。初产妇在分娩后1天（p = 0.003）和3天（p = 0.02）血清IL-1RA水平显著高于经产妇，但分娩前无差异。初产妇在分娩前后血清sCD8水平也低于经产妇，而血清PEP活性则高于经产妇。
结果表明，初产妇比经产妇遭受更大的焦虑，且具有不同的神经免疫反应性，初产妇焦虑水平的升高可能与IRS和血清PEP活性的变化有关。
