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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Daily psychosocial stressors interfere with the dynamics of urine neopterin in a patient with systemic lupus erythematosus: an integrative single-case study.
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Daily psychosocial stressors interfere with the dynamics of urine neopterin in a patient with systemic lupus erythematosus: an integrative single-case study.

机译：每日的社会心理压力因素会干扰系统性红斑狼疮患者尿新蝶呤的动力学：单项综合研究。

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OBJECTIVE: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by flare-ups, the causes of which are not known. In accordance with new concepts in stress research, this study investigated whether daily psychosocial stressors interfere with immunological processes in SLE. Because such processes are unique to each individual, single-case design using time-series analysis (Box and Jenkins) was applied. METHODS: A 40-year-old woman with SLE (last flare-up September 1995) was interviewed initially to determine major life events and difficulties (using the Life Events and Difficulties Schedule) in the previous 2 years. She was then observed for 63 days. Urine neopterin, an immunological parameter demonstrated to parallel disease activity in SLE patients, was measured in daily overnight urine. Daily incidents were identified weekly by the Incidents and Hassles Inventory and independently rated. Intervening factors, including infections, medication, and lifestyle, were controlled. RESULTS: Retrospectively, data obtained from the Life Events and Difficulties Schedule indicated that major life events and difficulties had preceded the patient's last flare-up in 1995. Although there were no clinical signs of SLE during this prospective study of 63 days, cross-correlational analyses revealed that "moderately" stressful incidents associated with higher levels of emotional irritation (lag 0: +0.271, p < .05) predicted an increase in urine neopterin the following day (lag 1: +0.441, p < .05). Moreover, a 7-day cyclicity in neopterin levels that corresponded to the weekly examinations and interviews was found. CONCLUSIONS: This study showed a causal relationship between psychosocial stressors and urine neopterin concentrations that may be related to SLE disease activity. Furthermore, the workability of an integrative approach using single-case design and time-series analysis in psychoneuroimmunology was demonstrated for the first time.
机译：目的：系统性红斑狼疮（SLE）是一种以发作为特征的慢性自身免疫性疾病，其病因尚不清楚。根据压力研究的新概念，该研究调查了日常的社会心理压力源是否会干扰SLE的免疫过程。因为这样的过程对于每个人都是唯一的，所以应用了使用时间序列分析的单案例设计（Box和Jenkins）。方法：最初采访了一名40岁的SLE妇女（1995年9月最后一次发作），以确定前两年的主要生活事件和困难（使用生活事件和困难时间表）。然后观察她63天。尿中的新蝶呤是一种免疫学参数，被证明与SLE患者的疾病活动平行，在每天的过夜尿液中进行测量。每日事件由“事件和麻烦清单”每周进行识别，并进行独立评估。干预因素，包括感染，药物治疗和生活方式，得到了控制。结果：回顾性地，从生活事件和困难时间表中获得的数据表明，主要的生活事件和困难发生在患者1995年最后一次发作之前。尽管在这项为期63天的前瞻性研究中没有SLE的临床体征，但存在相互关系分析显示，与较高程度的情绪刺激相关的“中度”压力事件（延迟0：+ 0.271，p <.05）预测第二天尿新蝶呤的增加（延迟1：+ 0.441，p <.05）。此外，发现新蝶呤水平为期7天的周期与每周的检查和访谈相对应。结论：本研究表明心理社会压力源与尿新蝶呤浓度之间的因果关系可能与SLE疾病活动有关。此外，首次证明了采用单例设计和时间序列分析的综合方法在心理神经免疫学中的可行性。

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