强迫症与抑郁障碍、焦虑障碍地塞米松抑制试验对照研究  

A Study of Dexamethasone Suppression Test in Patients with Obsessive-Compulsive Disorder

作　　者：肖泽萍[1] 陈珏[1] 张明岛[2] 徐勇[1] 邹政[1] 严和骎[1] 王振[1] 

机构地区：[1]上海市精神卫生中心心身科,上海200030 [2]上海市精神卫生研究所神经生理室

出　　处：《上海交通大学学报（医学版）》2006年第4期368-370,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生系统"百人计划"课题(沪卫97BR030)资助项目

摘　　要：目的研究地塞米松抑制试验(DST)在强迫症发病机制中的作用及其对强迫症诊断的价值。方法采用放射免疫测定法测定了29例强迫症(OCD)、27例正常对照(NC)、20例抑郁障碍对照(DD)和17例焦虑障碍对照者(AD)DST皮质醇含量结果OCD患者DST阳性率为24.1%,与各对照组比较无显著性差异(P>0.05);OCD患者8:00血浆基础皮质醇浓度显著高于正常对照组(P<0.01);DST阳性的7例OCD患者中6例(85.7%)为男性。结论OCD中存在一组患者DST脱抑制、下丘脑垂体-肾上腺轴活动过度,该结果独立于抑郁;DST对OCD的诊断作用较小。Objective To explore the role of dexamethasone suppression test （DST） in the pathophysiological mechanism of obsessive-compulsive disorder（OCD） and its diagnostic value. Methods The cortisol levels of 29 OCD patients,27 normal controls,20 controls of depressive disorder and 17 controls of anxiety disorder were determined with radioimmunoassay. Results 24. 1% of the OCD patients had abnormal DSTs, with no significant differences between the OCD group and each control group （P 〉0.05）. The plasma basal cortisol level of 8AM was significantly lower in the OCD group than the normal controls（P 〈0.01）. Among the 70CD patients who escaped suppression, 6 （85.7%） were male. Conclusion There is a subgroup of OCD patients who have abnormal DSTs and have hyper-activity with HPA axis independent of depression. The diagnostic value of DST is low in OCD.

关 键 词：强迫症 抑郁障碍 焦虑障碍 地塞米松抑制试验 诊断 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.7[医药卫生—临床医学]