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创伤后应激障碍女性青少年在 2008 年汶川地震后的头发皮质醇水平作为下丘脑-垂体-肾上腺活动改变的生物标志物。

Hair cortisol level as a biomarker for altered hypothalamic-pituitary-adrenal activity in female adolescents with posttraumatic stress disorder after the 2008 Wenchuan earthquake.

机构信息

The Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Biol Psychiatry. 2012 Jul 1;72(1):65-9. doi: 10.1016/j.biopsych.2011.12.020. Epub 2012 Feb 1.

Abstract

BACKGROUND

The present study evaluated the accumulated changes in hair cortisol levels of patients with posttraumatic stress disorder (PTSD) attributed to the 2008 Wenchuan earthquake in China.

METHODS

Sixty-four female adolescents from two townships who experienced the earthquake were recruited 7 months after the disaster, including 32 subjects with PTSD (PTSD group) and 32 subjects without PTSD (non-PTSD group). Twenty matched adolescents were recruited from an area that was not affected significantly by the earthquake as the control group. Hair cortisol concentrations were measured by the electrochemiluminescence immunoassay in each 3-cm segment of hair sample from the scalp.

RESULTS

There was no significant difference at the baseline hair cortisol level in the three groups before the traumatic event (p > .6). Hair cortisol levels changed over time and differed among groups (p = .0042). The hair cortisol levels among the PTSD and non-PTSD subjects were elevated, suggesting increasing levels in response to stress. However, these two groups differed in their response. The non-PTSD subjects showed a significantly higher cortisol level than the PTSD group between month 2 and month 4 (p = .0137) and also between month 5 and month 7 (p = .0438) after the traumatic event.

CONCLUSIONS

This study revealed a blunted response curve to the disaster among PTSD subjects compared with subjects without PTSD. These findings suggest that hair cortisol level could be used to assess the integrated hypothalamic-pituitary-adrenal activity over a period of months after traumatic events and be used to serve as a biomarker in patients with PTSD.

摘要

背景

本研究评估了归因于中国 2008 年汶川地震的创伤后应激障碍(PTSD)患者的头发皮质醇水平的累积变化。

方法

灾难发生后 7 个月,从两个乡镇招募了 64 名经历过地震的女性青少年,包括 32 名 PTSD 患者(PTSD 组)和 32 名无 PTSD 患者(非 PTSD 组)。从未受地震显著影响的地区招募了 20 名匹配的青少年作为对照组。用电化学发光免疫分析法测量头皮每 3 厘米发段的头发皮质醇浓度。

结果

在创伤事件发生前,三组之间的基线头发皮质醇水平没有显著差异(p>.6)。头发皮质醇水平随时间变化且组间存在差异(p=.0042)。PTSD 和非 PTSD 患者的头发皮质醇水平升高,表明皮质醇水平升高以应对压力。然而,这两组的反应不同。非 PTSD 组在创伤后第 2 个月至第 4 个月(p=.0137)和第 5 个月至第 7 个月(p=.0438)时,皮质醇水平显著高于 PTSD 组。

结论

与无 PTSD 患者相比,PTSD 患者对灾难的反应曲线较为迟钝。这些发现表明,头发皮质醇水平可以用来评估创伤后数月内下丘脑-垂体-肾上腺活动的综合情况,并作为 PTSD 患者的生物标志物。

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