情感性精神障碍病人ACTH增高对睾酮的作用  

Effect of the elevated ACTH on serum levels of testosterone in affective disorder patients

作　　者：王伏虎[1] 刘瑞玫[1] 江红卫[1] 凌四海[1] 刘敏[1] 程宇航[1] 

机构地区：[1]首都医科大学附属北京安定医院临床检验与实验中心,100088

出　　处：《神经疾病与精神卫生》2009年第6期500-502,共3页Journal of Neuroscience and Mental Health

摘　　要：目的本研究通过观察情感性精神障碍发作入院病人血清总睾酮（TES），皮质醇（COR），与血浆促肾上腺皮质激素（ACTH）升高的关系，探讨情感性精神障碍患者HPA轴的改变对性腺激素水平的作用。方法应用化学发光免疫分析法，检测急性发作入院的男性情感性精神障碍病人（80例）和精神分裂症患者（75例）血浆ACTH及血清TES、COR水平。结果情感性精神障碍病人和精神分裂症病人血浆ACTH水平均显著高于正常对照组（47士29）pg／mlvs（19±11）pg／ml（P〈0．01），（54±33）pg／mlvs（19±11）pg／ml，P〈0．01，而血清TES和COR与对照组比较无统计学意义；以ACTH≥50pg／ml为增高组，以ACTH（50pg／ml为正常组分组，ACTH异常的情感性精神障碍病人血清TES浓度均显著高于ACTH正常的情感性精神障碍患者和对照组（623±233）mg／dlvs（412±274）mg／dl，P〈0．01，（623±233）mg／dlvs（469±171）mg／dl，（P〈0．01），血清COR浓度亦高于ACTH正常的情感性障碍患者和对照组（19．8±5．]）μg／dlvs（16．2±6．5）μg／dl，P〈0．01，（19．8±5．1）pg／dlvs（17．4±5．2）μg／dl vs，P〈0．05），ACTH的升高与TES、COR呈正相关（r=0．495，P〈0．01，r=0．345，P〈0．01）。结论情感性精神障碍病人ACTH增加，导致COR、TES的异常分泌，HPA轴的激活，可以引起性腺激素的分泌增加。进一步研究ACTH变化的内在规律，将对揭示情感障碍的发病机制有重要作用。Objective To observe whether the elevated ACTH is associated with concentrations of testosterone and cortisol in patients with acute attack of affective disorder, and to explored the change of HPA axis. Methods Total testosterone, cortisol and ACTH were measured in 80 affective disorder males, 75 schizophrenia using chemiluminescent immunoanalysis. Results Plasma ACTH concentrations were significantly elevated in affective disorder and schizophrenia patients compared with control （47 ± 29） pg/mlvs （19±11） pg/ml（P〈0.01）, （54±33） pg/mlvs （19±11） pg/ml）. However, there was no significant difference in serum testosterone and cortisol concentrations in mood disorder with schizophrenia patients. There were significant intra--group differences in serum testosterone and cortisol with higher ACTH （ACTH 3 50 pg/ml）. Testosterone and cortisol levels were significantly increased in affective disorder patients with ACTH 3 50 pg/ml （P 〈 0. 001） （mean＋/-- SE level of 623＋/-- 233mg/ dl, 19. 8＋/-- 5. lug/dl） than in other affeetive disorder patients （412＋/--274mg/dl, 16. 2 ＋/-- 6.5μg/dl）. The higher ACTH was correlated with an alteration in Testosterone and cortisol concentration in affective disorder patients （r = 0. 495, r = 0. 345）, while no significant association was observed in schizophrenia patients. Conclusions ACTH may directly affect testosterone and cortisol in mood dis- order. The activation of the hypothalamic-- pituitary-- adrenal system in affective disorder may affect sexual hormone secretion. Further study of changes in the role of ACTH the human body is essential to reveal the pathogenic mechanism in affective disorder.

关 键 词：情感性精神障碍 ACTH增高 睾酮 神经病学 

分 类 号：R74[医药卫生—神经病学与精神病学]