强迫症患者血小板5-羟色胺、血浆催乳素及地塞米松抑制试验的研究  

Platelet serotonin,plasma prolactin and dexamethasone suppression test in patients with obsessive-compulsive disorder

作　　者：陈珏[1] 肖泽萍[1] 林治光[2] 王克勋[2] 邹政[1] 徐勇[1] 王振[1] 张明岛[3] 

机构地区：[1]上海市精神卫生中心心身科,200030 [2]上海市精神卫生中心精神卫生研究所生化室,200030 [3]上海市精神卫生中心电生理室,200030

出　　处：《中华精神科杂志》2004年第1期14-17,共4页Chinese Journal of Psychiatry

基　　金：上海市卫生系统百人计划资助项目 (97BR0 3 0 )

摘　　要：目的　从神经递质与神经内分泌角度探讨强迫症的生化病理机制。方法　采用高效液相色谱法及放射免疫测定法 ,分别测定 2 9例强迫症患者和 2 8名正常对照者血小板 5 羟色胺 (5 HT)含量及血浆催乳素 (PRL)含量 ,并进行地塞米松抑制试验 (DST)。结果　强迫症组血小板 5 HT水平[(0 8± 1 0 )nmol/10 9个血小板 ]低于正常对照组 [(1 4± 1 2 )nmol/10 9个血小板 ],差异有显著性 (P <0 0 5 ) ;而血浆PRL水平 [(337± 192 )nmol/L]与对照组 [(2 87± 116 )nmol/L]相比 ,差异无显著性 (P >0 0 5 ) ;强迫症组于晨 8时的血浆基础皮质醇含量 [(375± 15 2 )nmol/L]高于正常对照组 [(2 6 2± 138)nmol/L],差异有非常显著性 (P <0 0 1) ,其DST阳性率为 2 4 %～ 17% ,与正常对照组 (14 %～ 11% )相比 ,差异无显著性 (P >0 0 5 )。结论　强迫症患者存在 5 HT能低下和神经内分泌功能的紊乱 ,强迫症的 5 HT能假说能解释其某些内分泌功能紊乱。Objective The aim of this study was to explore the abnormalities of neurotransmitter and neuroendocrine in patients with obsessive-compulsive disorder (OCD). Methods Twenty-nine patients with OCD and 28 healthy normal controls were involved in the study. Platelet serotonin level was determined with high performance liquid chromatography,and plasma prolactin and cortisol level was measured with radioimmunoassay. The dexamethasone suppression test (DST) was conducted as well. Results Platelet serotonin was significantly lower in patients than in controls (P<0.05). There was no significant difference between the two groups in plasma prolactin (P>0.05). Plasma basal cortisol level at 8 am were significantly lower in OCD patients than in controls (P<0.01). The positive rate of DST in OCD was 24%-17%,which was not significantly different from control group (14%-11%;P>0.05). Conclusions There are lower serotonin function and neuroendocrine impairments in OCD patients,which supports the hypothesis of serotonin dysfunction in OCD.

关 键 词：强迫症 血小板 5-羟色胺 血浆催乳素 地塞米松 神经递质 神经内分泌 OCD 精神卫生 

分 类 号：R749.7[医药卫生—神经病学与精神病学]