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生活应激事件所致慢性应激及其在原发性干燥综合征发病中的作用:一项使用改良版霍姆斯-拉赫压力量表的对比分析

Chronic stress resulting from stressful life events and its role in the onset of primary Sjögren's syndrome: a comparative analysis using the modified Holmes-Rahe stress scale.

作者信息

Jaskólska Marta, Kościńska-Shukla Iga, Jaskólski Dawid, Viti Alessandro, Ziętkiewicz Marcin, Chmielewski Michał

机构信息

Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Second Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Stress. 2025 Dec;28(1):2447868. doi: 10.1080/10253890.2024.2447868. Epub 2025 Jan 10.

Abstract

Recent years brought considerable attention to the connection between chronic stress and the development of autoimmune diseases. However, little is still known about the impact of prolonged stress reactions on the onset and course of primary Sjögren Syndrome (pSS). This study aimed to seek for associations between chronic stress, resulting from stressful life events, and pSS. In the study, 50 patients with diagnosed pSS, as well as 50 control patients with osteoarthritis underwent an assessment. Modified Holmes-Rahe (H-R) stress scale was used in order to evaluate the impact of stressful events within 12 months prior to the diagnosis. Patients with pSS had a significantly higher total score on H-R stress scale within one-year preceding the disease diagnosis (152 ± 66.3 vs 50 ± 54.6;   0.001). Additionally, the pSS patients more commonly than the controls reported a subjectively perceived correlation between stressful events and the occurrence of disease symptoms (50% vs 12%;   0.001). Moreover, the H-R score at the time of the assessment correlated with the disease activity. The results support the view that pSS belongs to the group of diseases which pathogenesis is closely related to stressful life events. The novelty of this work lies in focus on both the correlation of stress on the onset of autoimmune disease as well as the activity of previously diagnosed disorder. Our data contributes to finding evidence-based medicine (EBM) arguments to what has until recently been merely a thematic observation-the harmfulness of negative stress on individual's health status.

摘要

近年来,慢性应激与自身免疫性疾病的发展之间的联系受到了广泛关注。然而,关于长期应激反应对原发性干燥综合征(pSS)的发病和病程的影响,我们仍知之甚少。本研究旨在探寻由应激性生活事件导致的慢性应激与pSS之间的关联。在该研究中,50例已确诊pSS的患者以及50例骨关节炎对照患者接受了评估。采用改良的霍尔姆斯-拉赫(H-R)应激量表来评估诊断前12个月内应激事件的影响。pSS患者在疾病诊断前一年的H-R应激量表总分显著更高(152±66.3 vs 50±54.6;P = 0.001)。此外,pSS患者比对照组更常报告主观上认为应激事件与疾病症状的出现之间存在关联(50% vs 12%;P = 0.001)。而且,评估时的H-R评分与疾病活动度相关。这些结果支持了pSS属于发病机制与应激性生活事件密切相关的疾病组这一观点。这项工作的新颖之处在于既关注了应激与自身免疫性疾病发病的相关性,也关注了先前诊断疾病的活动度。我们的数据有助于为直到最近还只是一个主题性观察结果——负面应激对个体健康状况的有害性,找到循证医学(EBM)依据。

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