情感危机所致创伤后应激障碍病人心身健康状况与血浆皮质醇水平变化

目的探讨情感危机所致创伤后应激障碍（PTSD）病人的心身健康状况及血浆皮质醇水平的变化。方法采用美国《精神疾病诊断与统计手册》第4版（DSM-Ⅳ）诊断标准,收集情感危机所致PTSD病人28例为研究对象,进行PTSD症状调查,测查症状自评量表（SCL-90）,并用放射免疫法检测血浆皮质醇浓度。结果 28例病人中,PTSD症状出现频率较高的依次是兴趣爱好范围变窄（100.00%）,激惹或易发怒（96.43%）,难以入睡或睡眠不深与难以集中注意力（均为92.86%）,不由自主地重现创伤事件（89.29%）,情感范围有所限制（85.71%）。PTSD组SCL-90总分及9个因子分均高于常模（t=6.367～13.114,P〈0.01）。PTSD组血浆皮质醇浓度低于对照组（t=2.221,P〈0.05）。结论情感危机所致PTSD严重影响病人心身健康,较多出现警觉性增高症状;其血浆皮质醇浓度低于正常水平。

CHANGES OF PSYCHOSOMATIC HEALTH STATUS AND PLASMA LEVEL OF CORTISOL IN PATIENTS WITH POST-TRAUMATIC STRESS DISORDER AFTER EMOTIONAL CRISES

Objective To observe the changes of psychosomatic health status（PHS） and plasma levels of cortisol in patients with post-traumatic stress disorder（PTSD） after emotional crises. Methods According to the criteria of ＂Diagnostic and Statistic Manual of Mental Disorders＂,28 patients with PTSD caused by emotional crises were investigated with Symptom Checklist-90（SCL-90）.The plasma level of cortisol was tested by radio-immunity technique. Results Of the 28 patients,the higher frequency of occurrence of symptoms of PTSD was in the following order： narrowing scope of interests（100.00%）,irritation or easy to get angry（96.43%）,difficulty falling asleep（92.86%）,impaired concentration（92.86%）,repetition of insult events（89.29%）,and restricted range of affection（85.71%）.The total SCL-90 score and score of the nine factors of PTSD group were higher than those of the control group（t=6.367-13.114,P0.01）,and the plasma level of cortisol was lower than those of the control（t=2.221,P0.05）. Conclusion The physical and mental health of patients with PTSD after emotional crises are seriously affected,manifesting with more alertness,and their plasma level of cortisol is lower than normal limit.