压力大,危害大……压力大或增加患病风险 | JAMA
2018/06/30
继有研究表明压力大会缩短寿命、加速癌细胞生长、改变身体器官后,最新发表在顶级医学期刊JAMA上的一篇论文再次证实了压力大的危害。研究发现,创伤或巨大的压力可能会增加患自身免疫性疾病的几率。


图片来源:JAMA(doi:10.1001/jama.2018.7028)

在题为“Association of Stress-Related Disorders With Subsequent Autoimmune Disease”的论文中,科学家们将106,000多名患压力障碍(stress disorders)的人与超过100万未患该疾病的人进行了比较。结果发现,压力与患41种自身免疫性疾病(包括类风湿性关节炎、牛皮癣、克罗恩病等)的风险增加36%有关。

正常情况下,身体的免疫系统会保护我们不受疾病和感染的危害,但自身免疫性疾病患者的免疫系统则会攻击健康细胞。目前,科学家们还不清楚是什么导致了自身免疫性疾病,但它们往往是家族性的。此外,女性患某些自身免疫性疾病的风险更高。

论文第一作者Huan Song博士说:“在遭受创伤或其他生活压力后出现严重情绪反应的患者应该寻求医学治疗,因为这些症状具有慢性风险,会进一步导致健康下降,如增加患自身免疫性疾病的风险。”

图片来源:16sucai

Song博士认为,用药物或认知行为疗法治疗与压力相关的疾病(stress-related disorders)可能会有助于降低患自身免疫性疾病的风险,例如,用抗抑郁药(如SSRIs)治疗创伤后应激障碍(PTSD)患者。

一位PTSD专家称,严重的压力与多种健康问题有关。虽然还不清楚为什么压力会增加患自身免疫性疾病的几率,但美国Northwell Health医疗集团的Mayer Bellehsen提出了几种可能的解释。

他说:“这些解释包括压力对生活方式的影响,如睡眠减少、增加药物或酒精的使用。此外,压力也可能会直接影响神经系统。不过,不管压力增加患自身免疫性疾病风险的原因是什么,这项研究都进一步证明了压力状况与身体健康之间的关联。”

最后值得一提的是,Song博士强调,由于这是一项观察性研究,因此并不能证明压力会导致自身免疫性疾病,只能证明两者之间存在关联。

责编:风铃

参考资料:

Severe stress may send immune system into overdrive

3篇论文证实!“压力大”缩短寿命、加速癌细胞生长……

所有文章仅代表作者观点,不代表本站立场。如若转载请联系原作者。
查看更多
  • Association of Stress-Related Disorders With Subsequent Autoimmune Disease

    Importance Psychiatric reactions to life stressors are common in the general population and may result in immune dysfunction. Whether such reactions contribute to the risk of autoimmune disease remains unclear. Objective To determine whether there is an association between stress-related disorders and subsequent autoimmune disease. Design, Setting, and Participants Population- and sibling-matched retrospective cohort study conducted in Sweden from January 1, 1981, to December 31, 2013. The cohort included 106 464 exposed patients with stress-related disorders, with 1 064 640 matched unexposed persons and 126 652 full siblings of these patients. Exposures Diagnosis of stress-related disorders, ie, posttraumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions. Main Outcomes and Measures Stress-related disorder and autoimmune diseases were identified through the National Patient Register. The Cox model was used to estimate hazard ratios (HRs) with 95% CIs of 41 autoimmune diseases beyond 1 year after the diagnosis of stress-related disorders, controlling for multiple risk factors. Results The median age at diagnosis of stress-related disorders was 41 years (interquartile range, 33-50 years) and 40% of the exposed patients were male. During a mean follow-up of 10 years, the incidence rate of autoimmune diseases was 9.1, 6.0, and 6.5 per 1000 person-years among the exposed, matched unexposed, and sibling cohorts, respectively (absolute rate difference, 3.12 [95% CI, 2.99-3.25] and 2.49 [95% CI, 2.23-2.76] per 1000 person-years compared with the population- and sibling-based reference groups, respectively). Compared with the unexposed population, patients with stress-related disorders were at increased risk of autoimmune disease (HR, 1.36 [95% CI, 1.33-1.40]). The HRs for patients with posttraumatic stress disorder were 1.46 (95% CI, 1.32-1.61) for any and 2.29 (95% CI, 1.72-3.04) for multiple (≥3) autoimmune diseases. These associations were consistent in the sibling-based comparison. Relative risk elevations were more pronounced among younger patients (HR, 1.48 [95% CI, 1.42-1.55]; 1.41 [95% CI, 1.33-1.48]; 1.31 [95% CI, 1.24-1.37]; and 1.23 [95% CI, 1.17-1.30] for age at ≤33, 34-41, 42-50, and ≥51 years, respectively; P for interaction < .001). Persistent use of selective serotonin reuptake inhibitors during the first year of posttraumatic stress disorder diagnosis was associated with attenuated relative risk of autoimmune disease (HR, 3.64 [95% CI, 2.00-6.62]; 2.65 [95% CI, 1.57-4.45]; and 1.82 [95% CI, 1.09-3.02] for duration ≤179, 180-319, and ≥320 days, respectively; P for trend = .03). Conclusions and Relevance In this Swedish cohort, exposure to a stress-related disorder was significantly associated with increased risk of subsequent autoimmune disease, compared with matched unexposed individuals and with full siblings. Further studies are needed to better understand the underlying mechanisms.

    展开 收起
发表评论 我在frontend\modules\comment\widgets\views\文件夹下面 test