运动应激试验前后血清皮质醇和IL-6水平与白大衣性高血压的关系

目的探讨运动应激试验前后血清皮质醇和IL-6水平的变化及其与白大衣性高血压的关系。方法选取2014年1月至2016年8月该院收治的白大衣性高血压患者48例作为研究组,选取同期普通高血压患者30例作为普通组和30例健康体检者作为对照组。3组均在空腹状态,在功率200 W的自行车上以蹬车2min后间歇5min再重复运动直至极度疲劳,完成运动应激试验。检测比较3组运动前、运动后即刻及运动后3h的血清皮质醇和IL-6水平及平均动脉压(MAP),分析血清皮质醇和IL-6水平对白大衣性高血压的诊断价值及其与患者MAP的关系。结果与对照组比较,研究组和普通组运动前后的血清皮质醇和IL-6水平及MAP均升高;与普通组比较,研究组运动前后的血清皮质醇和IL-6水平及MAP均升高(P0.05)。研究组运动后即刻及运动后3h的血清皮质醇和IL-6水平及MAP均较运动前升高(P0.05)。ROC曲线分析结果显示,运动应激试验前后血清皮质醇和IL-6水平对白大衣性高血压的诊断价值良好,其中以运动后即刻血清皮质醇和IL-6水平联合诊断白大衣性高血压的价值最优。Pearson线性相关分析结果显示,运动应激试验前后血清皮质醇和IL-6水平与白大衣性高血压MAP均呈正相关(r分别为0.844、0.802,P0.05)。结论运动应激试验前后血清皮质醇和IL-6水平对白大衣性高血压的诊断价值良好且与其血压水平相关,可能作为白大衣性高血压诊断和病情评估的参考指标。     

Evaluation of stress and pain during rapid maxillary expansion treatments

Summary The purpose of this study was to use salivary cortisol levels, pressure pain threshold (PPT) and Spielberger’s State‐Trait Anxiety Inventory for Children (STAIC) to assess stress, anxiety and pain during the expansion and retention phase of rapid maxillary expansion (RME) in children and investigate to whether this parameters are associated with gender or skeletal maturity stages. STAIC was used to assess the anxiety levels of the children. Salivary samples were collected for stress hormone determination. Visual Analog Scale was used for pain determination. Pressure pain threshold (PPT) was measured by using algometer. Data collection was performed a week before RME treatment (T0), at the day of the expansion appliance was bonded (T1), at the days of 1st, 4th, 7th, 14th, 25th, 36th activations of expansion screw (T2, T3, T4, T5, T6, T7) and after the retention period of 3 months (T8). The results of this study showed that the differences were statistically significant within‐day (P < 0·001) and within‐hours (P < 0·001) in cortisol levels during treatment. PPT levels were statistically significant within sex differences and skeletal maturity stages (P < 0·05). State‐trait anxiety scale scores were similar with respect to gender (P > 0·05). There were statistically significant differences of state‐trait anxiety levels between pre and post‐treatment stages (P < 0·05). The maximum number of patients reporting pain were days at T3 and T4. From day T5 the percentage of patients reporting pain then gradually reduced. Based on the findings of this study, it has been shown that RME leads to changes in patients’ state‐trait anxiety and cortisol levels.     

Pupil and salivary indicators of autonomic dysfunction in autism spectrum disorder

Dysregulated tonic pupil size has been reported in autism spectrum disorder (ASD). Among the possible sources of this dysregulation are disruptions in the feedback loop between norepinephrine (NE) and hypothalamic systems. In the current study, we examined afternoon levels of salivary alpha‐amylase (sAA, a putative correlate of NE) and cortisol (used to assess stress‐based responses) in two independent samples of children with ASD. We found a larger pupil size and lower sAA levels in ASD, compared to typical and clinical age‐matched controls. This was substantiated at the individual level, as sAA levels were strongly correlated with tonic pupil size. Relatively little diurnal variation in sAA taken in the home environment in the ASD group was also observed, while typical controls showed a significant linear increase throughout the day. Results are discussed in terms of potential early biomarkers and the elucidation of underlying neural dysfunction in ASD. © 2012 Wiley Periodicals, Inc. Dev Psychobiol 55: 465–482, 2013