Heitkemper M, Jarrett M, Cain K, Shaver J, Bond E, Woods N F, Walker E
Department of Biobehavioral Nursing, University of Washington, Seattle, USA.
Am J Gastroenterol. 1996 May;91(5):906-13.
There are few data on the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis in individuals with chronic GI symptoms. The current study was designed to describe and compare urine catecholamine (norepinephrine, epinephrine) and cortisol levels in women diagnosed with irritable bowel syndrome (IBS-patients), women who report similar symptom levels but had not sought health care services (IBS-nonpatients; IBS-NP), and asymptomatic (control) women.
Seventy-three women (24 IBS; 24 IBS-NP; 25 controls) were interviewed for demographic, GI, gynecological, and psychological data and then followed for two menstrual cycles with a daily health diary. Urine samples were obtained in the evening and morning at specific phases across two menstrual cycles.
Women in the IBS group had significantly higher PM and AM urine norepinephrine levels. Urine epinephrine and cortisol levels were also generally higher in women with IBS. Differences in neuroendocrine indicators of arousal were not accounted for by differences in demographic variables, lifestyle characteristics, menstrual distress, or average daily measures of anxiety or depression.
Increases in indicators of sympathetic nervous system activation in women seeking health care for IBS may reflect greater symptom distress or may contribute to increased symptom distress.
关于慢性胃肠道症状个体的交感神经系统和下丘脑 - 垂体 - 肾上腺轴的数据较少。本研究旨在描述和比较被诊断为肠易激综合征的女性（肠易激综合征患者）、报告有相似症状水平但未寻求医疗服务的女性（非肠易激综合征患者；IBS - NP）以及无症状（对照）女性的尿儿茶酚胺（去甲肾上腺素、肾上腺素）和皮质醇水平。
对73名女性（24名肠易激综合征患者；24名非肠易激综合征患者；25名对照者）进行了关于人口统计学、胃肠道、妇科和心理数据的访谈，然后通过每日健康日记对她们进行了两个月经周期的跟踪。在两个月经周期的特定阶段，于晚上和早晨采集尿样。
肠易激综合征组女性的下午和上午尿去甲肾上腺素水平显著更高。肠易激综合征女性的尿肾上腺素和皮质醇水平通常也更高。人口统计学变量、生活方式特征、月经不适或焦虑或抑郁的平均每日测量值的差异并不能解释唤醒的神经内分泌指标的差异。
因肠易激综合征寻求医疗服务的女性交感神经系统激活指标的增加可能反映了更大的症状困扰，或者可能导致症状困扰增加。
