焦虑症的生化病理机制探讨

目的：从神经递质与神经内分泌角度探讨焦虑症的生化病理机制。方法：采用高效液相色谱法及放射免疫测定法，分别测定25例焦虑症患者和28例正常对照者血小板5—羟色胺(5—HT)含量及血浆催乳素(PRL)含量、地塞米松抑制实验(DST)皮质醇含量。结果：广泛性焦虑(GAD)组血小板5—HT水平高于正常对照组，惊恐障碍(PD)组与正常对照组无显著差异；GAD组与对照组血浆PRL均极显著低于PD组；GAD组与PD组血浆基础皮质醇含量均显著高于正常对照组，两组DST阳性率均为20％，正常对照组为14．3％，3组阳性率无显著性差异；汉密尔顿焦虑量表(HAMA)评分与血浆皮质醇浓度呈显著正相关。结论：焦虑症患者存在神经递质和神经内分泌功能的紊乱，但不同亚型间可能存在不同的病理机制，皮质醇浓度可能是焦虑水平的标志因子。

Detection on pathophysiological mechanism in anxiety disorder

Objective:To explore the pathophysiological mechanism in anxiety disorder from the angles of neu-rotransmitter and neuroendocrine. Method:Twenty-five patients affected by anxiety disorder and 28 healthy controls were included in the study. Platelet serotonin level was determined with high performance liquid chromatograhy, and plasma prolactin and cortisol level were determined with radioimmunoassay. Results: Platelet serotonin was significantly higher in GAD patients than in controls, while there was no significant difference between controls and PD patients . The plasma prolactin concentration of GAD patients and controls was lower than PD patients, the difference was significant. Plasma basal cortisol level were significantly higher in GAD and PD patients than in controls. The nonsup-pressors rates of dexamethasone suppression test (DST) both were 20.0% in GAD and PD patients, and 14.3% in controls. Our data showed that DST did not significantly differentiate between the three groups. Hamilton anxiety scale score of anxiety patients significantly correlate with plasma cortisol concentration. Conclusion: There is neurotrans-mitter and neuroendocrine disorders in anxiety disorder. The different subtype may have different pathophysiological mechanism. The plasma cortisol concentration may reflect the level of anxiety.