9·11世贸中心袭击事件幸存者中C反应蛋白升高与创伤后应激病理状态
Elevated C-reactive protein and posttraumatic stress pathology among survivors of the 9/11 World Trade Center attacks.
作者信息
Rosen Rebecca L, Levy-Carrick Nomi, Reibman Joan, Xu Ning, Shao Yongzhao, Liu Mengling, Ferri Lucia, Kazeros Angeliki, Caplan-Shaw Caralee E, Pradhan Deepak R, Marmor Michael, Galatzer-Levy Isaac R
机构信息
NYU School of Medicine, Department of Psychiatry, 550 First Ave, New York, NY 10016, United States; Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, Ambcare 2E, 462 First Ave, New York, NY 10016, United States.
NYU School of Medicine, Department of Psychiatry, 550 First Ave, New York, NY 10016, United States; Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, Ambcare 2E, 462 First Ave, New York, NY 10016, United States.
出版信息
J Psychiatr Res. 2017 Jun;89:14-21. doi: 10.1016/j.jpsychires.2017.01.007. Epub 2017 Jan 16.
BACKGROUND
Systemic inflammation has emerged as a promising marker and potential mechanism underlying post-traumatic stress disorder (PTSD). The relationship between posttraumatic stress pathology and systemic inflammation has not, however, been consistently replicated and is potentially confounded by comorbid illness or injury, common complications of trauma exposure.
METHODS
We analyzed a large naturalistic cohort sharing a discrete physical and mental health trauma from the destruction of the World Trade Center (WTC) towers on September 11, 2001 (n = 641). We evaluated the relationship between multiple physical and mental health related indices collected through routine evaluations at the WTC Environmental Health Center (WTC EHC), a treatment program for community members exposed to the disaster. C-Reactive Protein (CRP), a marker of systemic inflammation, was examined in relation to scores for PTSD, PTSD symptom clusters (re-experiencing, avoidance, negative cognitions/mood, arousal), depression and anxiety, while controlling for WTC exposures, lower respiratory symptoms, age, sex, BMI and smoking as potential risks or confounders.
RESULTS
CRP was positively associated with PTSD severity (p < 0.001), trending toward association with depression (p = 0.06), but not with anxiety (p = 0.27). CRP was positively associated with re-experiencing (p < 0.001) and avoidance (p < 0.05) symptom clusters, and trended toward associations with negative cognitions/mood (p = 0.06) and arousal (p = 0.08).
CONCLUSIONS
In this large study of the relationship between CRP and posttraumatic stress pathology, we demonstrated an association between systemic inflammation and stress pathology (PTSD; trending with depression), which remained after adjusting for potentially confounding variables. These results contribute to research findings suggesting a salient relationship between inflammation and posttraumatic stress pathology.
背景
全身炎症已成为创伤后应激障碍（PTSD）潜在的有前景的标志物和潜在机制。然而，创伤后应激病理与全身炎症之间的关系尚未得到一致验证，并且可能受到共病或损伤（创伤暴露的常见并发症）的混淆。
方法
我们分析了一个大型自然队列，该队列因2001年9月11日世界贸易中心（WTC）双塔被毁而遭受了特定的身心健康创伤（n = 641）。我们评估了通过世贸中心环境卫生中心（WTC EHC）的常规评估收集的多个身心健康相关指标之间的关系，该中心是一个为受灾社区成员提供的治疗项目。我们检测了全身炎症标志物C反应蛋白（CRP）与PTSD评分、PTSD症状群（重新体验、回避、消极认知/情绪、唤醒）、抑郁和焦虑之间的关系，同时控制世贸中心暴露、下呼吸道症状、年龄、性别、体重指数和吸烟等潜在风险或混杂因素。
结果
CRP与PTSD严重程度呈正相关（p < 0.001），与抑郁呈正相关趋势（p = 0.06），但与焦虑无关（p = 0.27）。CRP与重新体验（p < 0.001）和回避（p < 0.05）症状群呈正相关，与消极认知/情绪（p = 0.06）和唤醒（p = 0.08）呈正相关趋势。
结论
在这项关于CRP与创伤后应激病理关系的大型研究中，我们证明了全身炎症与应激病理（PTSD；与抑郁呈正相关趋势）之间存在关联，在调整潜在混杂变量后这种关联仍然存在。这些结果有助于研究结果表明炎症与创伤后应激病理之间存在显著关系。
Zotero 插件