焦虑和抑郁障碍共病血浆单胺类神经递质研究

目的：探讨血浆单胺类神经递质与焦虑和抑郁障碍共病的关系。方法：使用高效液相－电化学检测法检测25例焦虑和抑郁障碍共病、30例抑郁症、20例焦虑症患者和21例正常人的血浆去甲肾上腺素（NE）和5－羟色胺（5－HT）浓度。结果：3组患者的血浆NE浓度均显著高于正常对照组,但共病组与抑郁症组和焦虑症组无明显差异;抑郁症组的血浆5－HT浓度显著低于正常对照组,共病组和焦虑症组的血浆5－HT浓度与正常对照组无显著差异,3组患者之间血浆5－HT浓度也无显著差异。结论：血浆单胺类神经递质不能鉴别抑郁症和焦虑症,也不支持焦虑和抑郁障碍共病是第3种疾病的观点。     

癫(疒间)患者事件相关电位和血浆单胺类神经递质水平的改变及其关系

目的探讨癫患者事件相关电位(ERP)和血浆单胺类神经递质水平的改变及其相关性。方法对50例癫患者进行ERP和血浆去甲肾上腺素(NE)、多巴胺(DA)和5-羟色胺(5-HT)水平检测,并与正常对照组比较。结果与正常对照组比较,癫组ERP的N2、P3波潜伏期延长,P3波幅明显降低(均P<0.01),血浆NE、DA和5-HT水平显著降低(均P<0.01)。癫组ERP的P3波潜伏期与血浆NE、DA和5-HT水平呈负相关(r=-0.33,r=-0.41,r=-0.46,均P<0.01),P3波幅与其呈正相关(r=0.32,r=0.39,r=0.48,均P<0.01)。结论癫患者有ERP异常和血浆单胺类神经递质水平降低;并且ERP异常程度与血浆单胺类神经递质水平相关。     

抑郁症患者脑电超慢涨落检测分析

目的:探讨抑郁症患者脑内神经递质活动变化。方法:应用中国北京ML2001脑电超慢涨落分析仪,通过对14例抑郁症患者于治疗前及治疗2、4周后脑电超慢涨落图(EFG),分析其谱线变化来反映脑内神经递质活动变化。结果:14例抑郁症患者治疗前脑内神经递质值与正常值对照比较,其5羟色胺(5HT)、乙酰胆碱(ACh)、去甲肾上腺素(NE)、多巴胺(DA)均降低,但以ACh、DA差异有显著性。治疗前及抗抑郁药治疗2、4周EFG值比较,其γ氨基丁酸(GABA)、谷氨酸(Glu)明显降低,而5HT、ACh、DA显著升高,差异有显著性。结论:脑内神经递质GABA、Glu、5HT、ACh、NE、DA间的协同不良可能导致了抑郁症发作,抗抑郁药治疗后脑内神经递质变化较大,单胺类递质活性增强。     

卒中后抑郁状态患者的血浆、脑脊液单胺类神经递质测定

目的　探讨卒中后抑郁状态与血浆、脑脊液单胺类递质水平的关系。方法　采用高压液相色谱仪 ,测定 32例卒中后抑郁状态患者、30例卒中后无抑郁状态患者及 2 8名正常人的血浆、脑脊液单胺类递质水平 ,进行对照分析。结果　卒中后抑郁状态患者血浆、脑脊液中单胺类递质水平[多巴胺 (DA) =(2 6± 0 4) μmol L ,(2 0± 0 3) μmol L ;去甲肾上腺素 (NE) =(0 19± 0 0 6 ) μmol L ,(0 14± 0 0 6 ) μmol L ;5 羟色胺 (5 HT) =(1 0 9± 0 30 ) μmol L ,(0 6 0± 0 12 ) μmol L]低于卒中后无抑郁组 [DA =(3 2± 0 5 ) μmol L ,(2 6± 0 4) μmol L ;NE =(0 31± 0 12 ) μmol L ,(0 2 8± 0 0 8) μmol L ;5 HT=(1 31± 0 40 ) μmol L ,(1 11± 0 40 ) μmol L]及正常对照组 [DA =(2 9± 0 5 ) μmol L ,(2 2± 0 6 )μmol L ;NE =(0 2 7± 0 70 ) μmol L ,(0 2 3± 0 0 8) μmol L ;5 HT =(1 19± 0 30 ) μmol L ,(0 88± 0 0 7)μmol L],而大脑左侧及前部卒中患者的血浆、脑脊液中单胺类递质水平低于其它卒中部位患者 (P <0 0 5 ) ,脑脊液单胺类递质水平与抑郁程度呈负相关 (P <0 0 5 )。结论　卒中后抑郁状态的发生与血浆、脑脊液中单胺类神经递质的降低有关     

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。     

抑郁症患者血浆白细胞介素与单胺代谢产物的研究

目的：探讨抑郁症患抗抑郁症治疗前后的细胞免疫及单胺类神经递质代谢产物的改变。方法：采用酶联免疫吸附法和高效液相电化学检测法，对40例抑郁症患在治疗前和抗抑郁药治疗4周后的血浆细胞因子白介素2（IL－2）和白介素6（IL－6），以及单胺代谢产物5－羟吲哚乙酸（5－HIAA）、3-甲基－4－羟－苯乙二醇（MHPG）和高香草酸（HVA）的浓度进行测定，并以20名健康人作为对照组。结果：（1）抑郁症组治疗前血浆IL－2、IL－6浓度明显高于正常对照组（P＜0．01），经过4周抗抑郁剂治疗后，随着病情显好转IL－2、IL－6较治疗前显降低（P＜0．01）；（2）抑郁症组治疗前血浆T－HIAA、MHPG、HVA浓度显低于正常对照组（P＜0．05），治疗后5－HIAA、MHPG明显高于治疗前（P＜0．05）；（3）治疗前后血浆5－HIAA的差值与治疗前后IL－2、IL－6的差值均呈显的负相关（P＜0．05）。结论：（1）抑郁症患可能伴有免疫激活和炎症反应。（2）抑郁症患存在中枢5－HT和NE功能低下。（3）IL－2、IL－6可影响中枢的5－HT活动。     

肝豆状核变性的血清和脑脊液递质的初步报告

本文应用萤光分光光度计测定44例肝豆状核变性患者血清及脑脊液的单胺类递质前体物一色氨酸和酪氨酸以及5—HT、5—HIAA、NE 和 DA 等。从42例的 CSF 值分析 DA、NE、5—HIAA 等浓度与正常人无显著差异。血清色氨酸较对照组增高,其增高原因尚待进一步探讨。     

帕金森病患者立体定向手术前后脑脊液单胺类递质含量的改变

目的　研究帕金森病 (PD)患者脑立体定向手术前后脑脊液 (CSF)中单胺类递质含量的变化。方法测定 2 6例原发性PD患者 (PD组 )脑立体定向术前、后CSF中多巴胺 (DA)、5 羟色胺 (5 HT)、去甲肾上腺素 (NE)及其代谢产物高香草酸 (HVA)、5 羟吲哚乙酸 (5 HIAA)、3 甲氧基 4羟基苯乙二醇 (MHPG)的含量 ,另外测定 2 5例外科疾病腰麻手术患者 (对照组 )CSF中HVA、5 HIAA、MHPG含量。结果　PD组CSF中HVA、5 HIAA、MHPG含量明显低于对照组 (P <0 0 0 1、P <0 0 5、P <0 0 0 1) ;手术后组的CSF中DA、HVA ,、5 HT、5 HIAA、NE、MHPG含量明显高于手术前组 (其中DA、HVA、5 HT、5 HIAA和NE均P <0 0 0 1;MHPGP <0 0 5 )。结论　PD患者CSF单胺类神经递质代谢产物含量明显降低 ,脑立体定向术可提高PD患者脑部单胺类神经递质及其代谢产物的含量 ,其发生机制可能与DA能神经元的保护作用有关     

卒中后抑郁单胺类递质与睡眠的研究

目的 探讨卒中后抑郁患者单胺类递质和睡眠结构的变化,以及二者的关系.方法 对46例卒中后抑郁患者和30例正常人进行血浆单胺类递质的测定以及多导睡眠图描记,将所得结果进行分析.结果 卒中后抑郁患者血浆中多巴胺、去甲肾上腺素、5-羟色胺、5-羟吲哚乙酸、高香草酸含量均显著低于对照组(P＜0.05);卒中后抑郁组与对照组相比,睡眠潜伏期及S1(%)时间延长,s3 S4(%)、REM、REM时间及潜伏期缩短,差异均有显著性(P＜0.05或P＜0.01);卒中后抑郁患者血浆NE、5-HT与REM、REM latency(%)均呈正相关(P＜0.05或P＜0.01).结论 卒中后抑郁存在单胺类神经递质及睡眠结构的改变,且睡眠障碍与单胺类神经递质变化有关.     

帕金森病伴发抑郁的神经递质改变

目的　探讨帕金森病 (PD)伴发抑郁的神经递质改变。方法　用抑郁自评量表 (CESD)和汉密尔顿抑郁量表 (HAMD)评出PD伴发抑郁患者 33例 ,其中轻度抑郁 2 4例 ,中、重度抑郁 9例 :另取阑尾炎、腹股沟疝气、内、外混合痔等 2 5例作为对照组。应用高效液相色谱仪 ,电化学检测器对两组患者进行了脑脊液 (CSF)中单胺类神经递质 5 羟色胺 (5 HT)的代谢产物 5 羟吲哚乙酸 (5 HIAA)和去甲肾上腺素 (NE)的代谢产物 3 甲氧基 4羟基苯乙二醇 (MHPG)的含量测定。结果　患者组CSF中的 5 HIAA和MHPG含量均低于对照组 ,P <0 .0 1,有显著性差异。结论　PD伴发抑郁的患者其CSF中 5 HIAA和MHPG含量显著减少 ,抑郁症状可能与 5 HT和 (或 )NE的缺乏有关。提示PD伴发抑郁有着相应的生化病理基础     

焦虑和抑郁障碍共病的血脂水平研究

目的　探讨血脂与焦虑和抑郁障碍共病的关系。方法　采用酶法检测焦虑和抑郁障碍共病 2 5例、30例重性抑郁症、2 0例焦虑症患者和 4 0例正常人的血清总胆固醇 (CHO)、甘油三酯 (TG)、高密度脂蛋白—胆固醇(HDL C)和低密度脂蛋白—胆固醇 (LDL C)。结果　共病组患者的血CHO浓度显著高于抑郁组、焦虑组和正常对照组 ;共病组的血TG浓度显著高于抑郁组和正常对照组 ,与焦虑组无显著性差异 ;共病患者的血HDL C浓度显著低于正常对照组 ,与抑郁组和焦虑组无显著性差异 ;共病组的血LDL C浓度显著高于抑郁组、焦虑组和正常对照组。结论　焦虑和抑郁障碍共病存在更严重的血脂代谢异常     

抑郁症患者血清胆固醇、脂蛋白和载脂蛋白的水平及其意义

目的 探讨抑郁症患者血清水平及其临床意义。方法 采用酶法及免疫比浊法检测６６例抑郁症和３６名健康对照者的血清胆固醇（ＴＣ），甘油三脂（ＴＧ），高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ）低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ），载脂蛋白ＡＩ（ａｐｏＡＩ）和载脂蛋白Ｂ（ａｐｏＢ）水平，并比较其中内源性抑郁患者（３４例）与非内源性抑郁患者（３２例），有自杀行为者（２５例）与无自杀行为者（４１例）的血脂水平。结果 与对     

Correlation between serum lipid,lipoprotein concentrations and anxious state,depressive state or major depressive disorder

The purpose of this study was to investigate the correlation between serum lipid, lipoprotein concentrations and anxious state, depressive state or major depressive disorder. A total of 207 patients admitted for general health screening were recruited during a 1-year period. Using the Chinese Health Questionnaire, the Taiwanese Depression Questionnaire and the semi-structured clinical interview for DSM-IV, one psychiatrist screened all participants for the presence of anxiety or depressive disorders. Blood samples for serum lipid and lipoprotein concentrations and physical examination records were collected simultaneously. For patients who did not have systemic diseases (n=162), we found that high-density lipoprotein (HDL) cholesterol and the ratio of total cholesterol (TC)/HDL differed significantly among anxious state, depressive state and normal groups in men after age adjustment. On the other hand, the ratios of TC/HDL and low-density lipoprotein (LDL)/HDL showed significant differences between patients with major depressive disorder and normal controls in women. This study suggested that the level of HDL cholesterol and the ratios of TC/HDL and LDL/HDL (atherogenic index) might be another markers of the possible association between serum lipids and anxiety or depression.     

Serum lipids after stroke

To ascertain the appropriate time for detecting lipid abnormalities for prophylaxis, serial analyses of fasting serum lipoproteins were undertaken prospectively in men with cerebral infarction or transient ischemic attacks. Serum total cholesterol (T CHOL) and low density lipoprotein cholesterol (LDL CHOL) in cerebral infarction patients aged 50 to 69 were lowest on day 7, intermediate on day 1, and highest at 3 months, whereas very low density lipoprotein and high density lipoprotein cholesterol (HDL CHOL) changed little. The day 1 mean fasting serum HDL CHOL of cerebral infarct patients was significantly lower in subjects aged 50 to 59 than in those aged 60 to 69 (23 +/- 3 versus 42 +/- 5 mg/dl), and there was a corresponding higher ratio of T CHOL:HDL CHOL (12.7 +/- 4.5 versus 4.7 +/- 0.4, p less than 0.01). Mean HDL CHOL levels were low normal to low in patients aged 50 to 69 with transient ischemic attacks. Both serum cholesterol and triglyceride levels are initially decreased in patients aged 50 to 69 with cerebral infarction, whereas only cholesterol is decreased in patients 60 to 69 with transient ischemic attacks. Important lipoprotein abnormalities may be missed in the acute phase.     

Low serum HDL‐cholesterol levels are associated with long symptom duration in patients with major depressive disorder

Aims: The purpose of the present study was to examine whether the association between depression and the serum high‐density lipoprotein cholesterol (HDL‐C) is modified by symptom duration. Methods: Depressed patients (n = 88) and an age‐ and sex‐matched group of healthy general population controls (n = 88) underwent a Structured Clinical Interview for DSM‐IV (SCID), and depressed participants reported the duration of their symptoms. The serum levels of total cholesterol (TC), HDL‐C, low‐density lipoprotein cholesterol (LDL‐C), triglycerides (TG) and non‐HDL, and the ratios of LDL‐C/HDL and TC/HDL‐C were assessed. Results: Major depressive disorder (MDD) subjects with a long symptom duration (≥3 years) had lower levels of HDL‐C compared with healthy controls or MDD subjects with a symptom duration <3 years. The likelihood for long symptom duration doubled for each 0.5‐mmol/L decrease in HDL‐C levels in regression models adjusted for age, gender, marital status, overweight, symptom severity, alcohol consumption, smoking, physical exercise, medication use, and non‐HDL‐C (P < 0.05). Conclusions: These findings suggest that a low serum HDL‐C level, a risk factor for coronary heart disease, is specifically associated with long‐term depressive symptomatology.     

急性脑卒中后焦虑抑郁共病状态血清单胺类递质的变化研究

目的探讨急性脑卒中后焦虑抑郁共病患者血清单胺类递质水平的关系。方法采用荧光分光光度计法测定33例急性卒中后焦虑抑郁共病患者、22例急性卒中后抑郁患者、49例卒中后非焦虑抑郁患者及37例正常人血清单胺类递质的水平。结果急性脑卒中后焦虑抑郁共病组和PSD组血清中，NE、5-HT、DA含量低于非焦虑抑郁组和对照组，共病组NE、5-HT高于抑郁组，其中5-HT差异有显著意义，而非焦虑抑郁组血清中，单胺类递质的含量亦低于对照组。而大脑左侧及前部卒中患者的血清中单胺类递质水平低于其它卒中部位患者（P〈0．05）。结论急性脑卒中后焦虑抑郁共病组和单纯PSD的发生与血清中单胺类神经递质的降低有关。     

复发性脑梗死血脂变化的临床意义

目的　探讨复发性脑梗死的血脂变化有无临床意义。方法　对 12 2例复发性脑梗死患者的血脂进行分析 ,并和同期同龄非心脑血管病患者的血脂进行对比。结果　复发性脑梗死组总胆固醇 (TC)、低密度脂蛋白 (LDL)及载脂蛋白B10 0 (ApoB)均明显高于对照组 ,而高密度脂蛋白 (HDL)、载脂蛋白AI(ApoA)及载脂蛋白AI/载脂蛋白B10 0 (A/B)比值均低于对照组。甘油三酯 (TG)略高于对照组。结论　复发性脑梗死患者存在血脂异常 ,应将血脂异常作为复发性脑梗死的一个危险因素     

血脂水平及血脂综合指标与抑郁障碍患者自杀意念、临床特征的关系

目的:探讨血脂水平及血脂综合指标与抑郁障碍(MDD)患者自杀意念及临床特征的关系。方法:根据汉密尔顿抑郁量表17项(HAMD-17)条目3"自杀"评分≥1为界将122例首发MDD患者分为有自杀意念组(94例)及无自杀意念组(28例);对两组人口学资料、HAMD-17各维度评分、血脂水平[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]及血脂综合指标[动脉硬化指数(AI)、血浆致动脉硬化指数(AIP)、脂蛋白结合指数(LCI)]进行比较;采用Pearson相关分析研究差异指标与自杀意念等临床特征的关系。结果:有自杀意念组TG和LCI明显低于无自杀意念组(P均<0.05)。血清TG水平与HAMD-17条目3的得分呈负相关(r=-0.221,P=0.015),与睡眠障碍因子分呈正相关(r=0.238,P=0.008)。患者LCI与HAMD-17条目3的得分(r=-0.260,P=0.004)及认知障碍因子分(r=-0.192,P=0.034)呈负相关,与睡眠障碍因子分呈正相关(r=0.203,P=0.025)。结论:血清TG水平和LCI降低与MDD患...     

Serum lipids, lipoprotein analysis and apoprotein A-I, A-II and B levels in Friedreich's ataxia

Serum lipid, lipoprotein and apoprotein parameters were evaluated in 15 patients (7 males and 8 females) with Friedreich's ataxia. Serum lipid levels in patients showed no significant differences compared to controls. Small reduction in serum phospholipid and in total HDL and HDL3 cholesterol levels were observed, and the female patients presented a slight reduced total cholesterol level; among the serum apoproteins, apo B was reduced only in the males. The most interesting findings concerned the lipoproteins, since both lipid and protein masses of the VLDL, LDL and HDL2 fractions were reduced. In reference to lipoprotein composition, however, HDL2 was the most modified fraction, showing an important protein reduction. From this point of view, this lipoprotein seems the most responsible for the changes observed in our patients. The meaning of this modified lipoprotein pattern in the pathophysiology of Friedreich's ataxia is not clear.     

Relation of serum cholesterol, lipid, serotonin and tryptophan levels to severity of depression and to suicide attempts

OBJECTIVE: To determine if there is a relation to low serum cholesterol, lipoprotein, serotonin or tryptophan levels in patients with depression who have recently attempted suicide. DESIGN: Biochemical and behavioural study. SETTING: Inpatient and outpatient treatment at the Instituto Mexicano de Psiquiatría. PARTICIPANTS: Thirty-three patients with a diagnosis of major depressive episode. Eighteen of these patients had attempted suicide in the month before the start of the study; 15 patients had never attempted suicide. OUTCOME MEASURES: Serum levels of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, serotonin (5-HT) and tryptophan. Scores on Hamilton Depression Rating Scale, Carroll Depression Rating Scale, Beck Hopelessness Scale and Beck Suicide Attempt Severity Scale. RESULTS: There were no significant differences between patients who had attempted suicide and those who had not in terms of serum cholesterol, HDL, LDL and triglyceride levels. Serum levels of 5-HT and tryptophan were significantly lower in patients with depression who had a recent suicide attempt than in those patients who had never attempted suicide. A comparison of patients not taking antidepressant medication found serum 5-HT levels to be more than 3 times lower in those patients with a recent suicide attempt than in patients with no history of suicide attempt. CONCLUSIONS: The study found no difference in lipid profiles between patients who had attempted suicide and those who had not. Low serum levels of 5-HT may increase the risk of suicide attempt in patients who are depressed.