迟发性运动障碍患者血浆超氧化物歧化酶和一氧化氮及一氧化氮合酶的变化

目的 探讨血浆超氧化物歧化酶(SOD)、一氧化氮(NO)及NO合酶(NOS)的变化与抗精神病药所敛的迟发性运动障碍(TD)的关系。方法 对42例长期使用抗精神病药治疗伴有TD的男性精神分裂症患者的血浆锰SOD(MnSOD)、铜-锌SOD(CuZnSOD)、NO及NOS的活性进行测定,以59例不伴有TD男性精神分裂症患者和50例健康男性作对照组,使用异常不自主运动量表(AIMS)进行临床评估。结果 TD组MnSOD、CuZnSOD和NO分别高于非TD组(P<0.05)或正常对照组(P<0.05),TD组NOS明显低于正常对照组(P<0.05)、略高于非TD组(p<0.05)。TD组MnSOD浓度越高则TD的症状越严重、NOS则相反(P<0.01),且在TD组MnSOD与NO呈显著的负相关(p<0.05)、在非TD组或正常对照组却呈正相关(前者P<0.01)。分层后发现TD组MnSOD浓度在NO较低时显著高于非TD组(P<0.01),而在NO浓度较高时则略低于非TD组(P>0.05)。结论 抗精神病药所致的TD,可能与患者血浆SOD尤其是MnSOD活性增高以及血浆NO浓度升高密切相关,两者可能来源于不同病理过程,但均提示自由基活动异常。

Changes of superoxide dismutase, nitric oxide and nitric oxide synthase activities in plasma of patients with tardive dyskinesia

Objective To study the relationship between changes of superoxide dismutase(SOD) , nitric oxide (NO) and NO synthase (NOS) activities in plasma and neuroleptic-induced tardive dyskinesia (TD). Methods The activities of Mn-SOD, CuZn-SOD, NO and NOS in plasma were measured, in 42 with and 59 without TD patients in schizophrenia, who had teen treated with long-term neuroleptics, and 50 normal controls. TD severity was assessed with the Abnormal Involuntary Movement Scale (AIMS) . Results There were significantly increased in Mn-SOD, CuZn-SOD and NO activities in plasma of the patients with TD as compared with non-TD ( P < 0.05) or normal controls ( P < 0.05) . NOS activities in plasma of TD group was significantly lower than normal controls ( P < 0.05) and higher than non-TD group ( P < 0.05) . The total scores of AMIS were correlated positively with Mn-SOD ( P < 0.05) and negatively with NOS ( P < 0.05) in TD group. There were negative correlation in TD group ( P < 0.05) , and positive correlation in non-TD group ( P < 0.01) and normal controls ( P > 0.05) between Mn-SOD and NO in plasma. In further analyisis, Mn-SOD activity in patients with TD was increased significantly in the lower level ( P < 0.01), and decreased in higher level (P>0.05) of NO concentration as compared with non-TD patients. Conclusions The high levels of SOD activities and /or NO concentration in plasma may be associated with neurolepitc-induced TD. These results sugest that increased free radical poroduction is probably involved in the pathogenesis of TD.