女性纤维肌痛综合征病人心理神经免疫反应的研究

Study on psychoneuroimmunological reaction of female patients with fibromyalgia syndrome

[目的]探讨女性纤维肌痛综合征(FMS)病人主观应激、疼痛、疲劳、抑郁、焦虑、功能状态之间及与免疫学生物标志物之间的关系。[方法]选择50例门诊就诊并自愿参加本研究的女性FMS病人,应用主观应激测量表(PSS)、简明疼痛量表(BPI)、简明疲劳量表(BFI)、中心流行病学研究抑郁量表(CES-D)、状态-特质焦虑量表(STAI)和纤维肌痛综合征影响问卷(FIQ)进行调查,并分析血浆中17种细胞因子的水平和酶联免疫吸附法测定C-反应蛋白(CRP)水平。[结果]主观应激与疼痛、疲劳、抑郁、焦虑和功能状态呈正相关,与单核细胞趋化蛋白(r=-0.37)和白细胞介素-1β(r=-0.36)呈负相关;疼痛严重程度与巨噬细胞炎性蛋白-1β(r=0.36)呈正相关,疼痛干扰与白细胞介素-1β(r=-0.37)呈负相关,疲劳与白细胞介素-1β(r=-0.39)和白细胞介素-10(r=-0.38)呈负相关,而与粒细胞集落刺激因子(r=0.38)呈正相关,抑郁症状与CRP(r=0.38)呈正相关。[结论]多种细胞因子及CRP水平与FMS症状相关。

Objective： To probe into the relationship among subjective stress, pain, fatigue, depression, anxiety and functional status of female patients with fibromyalgia syndrome and relationship between them and immunological biomarkers. Methods： A total of 50 cases of female patients with fibromyalgia syndrome diagnosed in Outpatient and vol- untarily participating in this study were selected, And they were inves- tigated by using perceived stress scale （PSS）, brief pain inventory （BPI）, brief fatigue Inventory （BFI）, center for epidemiological studies - depression scale（CES - D）, state - trait anxiety inventory （STAI）, and fibromyalgia impact questionnaire （FIQ）. Totally 17 plasma cytokine levels were analyzed and enzyme - linked immunosorbent was used to determine the level of C- reactive protein （CRP）. Results：Subjective stress was positively correlated with pain, fatigue, depression, anxiety, and functional status,was negatively correlated with the monocyte che- moattractant protein（r=-0. 36）and interleukin- 1 beta （r=-0. 37）. Sever- ity of pain was positively correlated with macrophage inflammatory protein- 1beta （r= 0. 36）. Pain was negatively correlated with IL - lbeta （r=-0.37）. Fatigue was negatively correlated with IL- 1beta （r= --0.39） and interleukin - 10 （r= -0.38） ,and was positively cor- related with granulocyte colony- stimulating factor （r=-0.38）. Depres- sive symptoms were positively correlated with CRP （r=0.38）. Conclu- sion：A variety of cytokines, CRP levels were associated with symptoms of FMS.