J Rheumatol:儿童期虐待与成年患系统性红斑狼疮的关联

2019-05-29 xiangting MedSci原创

与未受到虐待的女性相比,儿童期受到身体和情感虐待的女性患SLE风险明显升高。儿童期遭遇不幸有助于SLE的发展。

暴露于严重的压力源会改变免疫功能,并增加炎症和细胞因子的释放,使得自身免疫性疾病的风险升高。这项研究探讨了儿童期虐待是否与偶发性系统性红斑狼疮(SLE)的风险升高有关。

研究数据来自护士健康研究II,该研究为1989年入组的一个美国女护士队列,使用两年一次的问卷调查进行随访。使用童年期创伤问卷的身体和情绪虐待次级量表对儿童期身体和情绪虐待进行了测量,以及父母-儿童冲突战术量表的性虐待量表对性虐待进行了测量,两个量表均在2001年颁布。研究人员确定了2015年以前的偶发性SLE(> 4个1997年美国风湿病学会分类标准)。使用多变量Cox回归模型来评估儿童期虐待与SLE之间的关联,考虑到潜在的混杂因素(如父母教育、职业、房屋所有权)和中介疾病(如抑郁症、创伤后应激障碍(PTSD))。

在67,516名女性中,有94例偶发性SLE病例。在调整后的模型中,与最低虐待相比,暴露于最高的身体和情感虐待与SLE风险升高2.57倍相关(95%CI 1.30-5.12)。研究发现17%与虐待相关的SLE风险(p<0.0001)可以用抑郁症来解释,而23%可以用PTSD解释(p<0.0001)。没有发现SLE与性虐待有统计学关联(最高暴露vs.最低暴露 HR 0.84,95%CI 0.40-1.77)。

研究发现与未受到虐待的女性相比,儿童期受到身体和情感虐待的女性患SLE风险明显升高。儿童期遭遇不幸有助于SLE的发展。

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