创伤后应激障碍与抑郁症患者对小剂量地塞米松抑制试验的反应

目的 通过小剂量的地塞米松抑制试验来比较抑郁症与创伤后应激障碍（PTSD）患者的垂体-肾上腺轴功能.方法 采用酶联免疫吸附法（ELISA）测定30例抑郁症和PTSD 患者的血浆中皮质醇、促肾上腺皮质激素基线水平,并行小剂量地塞米松（0.35 mg）抑制试验后再测定两组血浆的皮质醇、促肾上腺皮质激素水平.结果 抑郁症和PTSD 患者的的血浆皮质醇、促肾上腺皮质激素（ACTH）基线水平的差异无统计学意义（P＞0.05）;PTSD 患者对小剂量地塞米松抑制试验与抑郁症组比较,表现为皮质醇和ACTH的降低,即呈现超敏反应（P〈0.05）.结论 PTSD 患者对小剂量地塞米松抑制试验呈现超敏现象,这恰恰为该类PTSD 患者存在持久亢进的垂体-肾上腺轴功能的假说提供了证据.

Pituitary-Adrenal Responses to Low-dose Dexamethasone Suppression Tests in Depressive Patients and Posttraumatic Stress Disorder

Objective To study Pituitary-adrenal function in depressive patients and posttraumatic stress disorder(PTSD)by low-dose dexamethasone suppression tests(DST).Methods Cortisol and ACTH level in blood plasma were determined in normal condition and in low-dose DST that were performed in depressive patients(n=30) and PTSD(n=30) Results In the low-dose DST,PTSD group exhibited greater cortisol and corticotropin suppression than depressive patients group(P<(0.05).) Conclusions Cortisol supersuppression is evident for thus hypothesis;persistent changes of pituitary-adrenal and corticotropin-releasing factor neuronal systems in PTSD than depressive patients.