压力相关疾病与随后的自身免疫性疾病的关联
Huan Song1,2, Fang Fang2, Gunnar Tomasson3,4,5
1Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
JAMA
|June 21, 2018
概括
患有压力相关疾病的人患自身免疫性疾病的风险更高. 这一关联在瑞典的一项队列研究中得到证实,强调了心理健康与免疫系统功能之间的联系.
科学领域:
- 精神病学
- 免疫学
- 流行病学
背景情况:
- 对压力的精神反应很常见,可能导致免疫功能障碍.
- 与压力相关的疾病与自身免疫性疾病风险之间的联系尚不清楚.
研究的目的:
- 研究与压力相关的疾病与随后发生自身免疫性疾病的风险之间的关联.
主要方法:
- 在瑞典 (1981-2013) 进行的一项回顾性队列研究包括超过106,000名患有压力相关疾病的患者和匹配的对照.
- 通过国家患者登记册确定了与压力相关的疾病和41种自身免疫疾病的诊断.
- 在与压力相关的疾病诊断后,考克斯模型估计了自身免疫疾病的危险比率 (HRs).
主要成果:
- 患有压力相关疾病的患者患自身免疫性疾病的风险显著增加 (HR,1. 36).
- 任何 (HR, 1.46) 和多重 (HR, 2.29) 自免疫疾病的风险都更高.
- 年轻患者的风险增加更明显,SSRI使用与风险降低有关.
结论:
- 与压力相关的疾病与随后自身免疫性疾病的风险显著增加有关.
- 在人口和兄弟匹配的比较中,结果一致.
- 需要进一步研究以阐明底层的生物机制.
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