肝炎时的应激与皮质醇、血管紧张素Ⅱ检测的意义

摘要

Objective　This study was carried out to investigate the relationship among the partial plasma hormones associated with the stress,main indices of liver function as well as psychical status in the patients with viral hepatitis(VH).Methods　Five indices of liver function,plasma cortisol(CT) and angiotensin Ⅱ(ATⅡ) were detected,the psychical tests were simultaneously carried out by survey item life events units(LEU),symptoms checklist 90(Scl-90).Results　Both CT and ATⅡ ascended in the acute period of various types VH and correlated with many indices of liver function(P＜0.05～0.001).The level of ATⅡ was positively correlated with several scores of Scl-90(P＜0.05～0.001).LES times in patients with VH were obviously higher than those of normal persons before onset/recurrence(P＜0.001).Six indices of Scl-90 ascended in chronic hepatitis(CH),presented somatization,depression,anxiety and psychical disorder(P＜0.05～0.001).Conclusion　CT and ATⅡ is valuable hormones associated with stress.AT Ⅱ is close correlate with psychical stress(PS).Psychicsocial factor is one of the important inducers for hepatitis onset/recurrence.%摘要探讨患病毒性肝炎时的应激状态下“激素、心理、肝功能”的相关性。方法在检测肝功能、血浆皮质醇(CT)及血管紧张素Ⅱ(ATⅡ)的同时进行心理测验(工具：生活事件量表，症状自评量表)。结果肝病患者急性期血浆CT、ATⅡ含量明显增高并与多项肝功能指标相关(P＜0.05～0.001)；ATⅡ含量与症状自评量表的多项得分呈正相关(P＜0.05～0.001)；肝炎病人发病/复发前遭遇的生活事件显著高于正常人(P＜0.001)；症状自评量表的测定在慢肝群体中有6项增高(P＜0.05～0.001)。结论 CT、ATⅡ为应激相关激素；ATⅡ与心理应激相关；心理社会因素是病毒性肝炎发生/复发的重要诱因之一。