目的:研究创伤后应激障碍(PTSD)患者的临床症状与血清皮质醇、5-羟色胺(5-HT)水平的相关性。方法:随机纳入PTSD患者36例(PTSD组),正常对照组36例,采用PTSD量表平民版(PCL-C)评估PTSD症状、抑郁自评量表(SDS)和焦虑自评量表(SAS)评估抑郁焦虑症状,并同步通过酶联免疫吸附测定检测血清皮质醇、5-HT水平。结果:PTSD组患者血清皮质醇、5-HT水平均显著低于正常对照组(tcortisol=-4.499,Pcortisol<0.001;t5-HT=-8.310,P5-HT<0.001);PTSD组患者SAS和SDS评分显著高于正常对照组(tSAS=14.610,PSAS<0.001;tSDS=11.581,PSDS<0.001);PCL-C评分方面,PTSD组总分、再体验、麻木与回避及警觉性增高方面,均显著高于正常对照组(ttotal=17.357,Ptotal<0.001;tre-experience=6.971,Pre-experience<0.001;tavoidance/numbness=14.362,Pavoidance/numbness<0.001;thyper-arousal=12.112,Phyper-arousal<0.001)。控制变量年龄和性别后,PTSD组血清皮质醇水平与焦虑、抑郁、再体验症状得分均呈负相关(ranxiety=-0.646,Panxiety=0.007;rdepression=-0.647,Pdepression=0.007;rre-experience=-0.533,Pre-experience=0.034);血清5-HT水平与焦虑、抑郁得分均呈负相关(ranxiety=-0.770,Panxiety<0.001;rdepression=-0.695,Pdepression=0.003)。结论:PTSD患者血清皮质醇、5-HT水平显著低于健康人群,且均与患者焦虑和抑郁情绪呈负相关,为临床上PTSD的早期预测、早期诊断提供更多的实验室指标。 |
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