精神分裂症患者的中枢多巴胺和5—羟色胺浓度及其性别差异

目的 了解精神分裂症中枢多巴胺（DA）与5－羟色胺（5－HT）相互作用的变化及其性别影响的程度。方法 应用高效液相色谱对符合CCMD－2精神分裂症诊断标准的30例男性病人、37例女性病人、21例男性对照组、9例女性对照组脑脊液中DA、5－HT及其代谢产物高香草酸（HVA）、5－羟吲哚乙酸（5－HIAA）进行测试，并应用5－HT／DA、5－HIAA／HVA作为它们的相互作用的指标。结果 5－HT／DA、5－HIAA／HVA在4组中有显著性差异（F＝3．567，P＝0．032；F＝12．464，P＝0．001），进一步分析提示；女性分裂症5－HT／DA显著低于男性对照组，且男性、女性分裂症及男性对照组5－HIAA／HVA均显著低于女性对照组。在男性病例组的相关分析中，5－HT／DA与BPRS及其阳性症状呈显著负漠、非特异性症状呈显著负、正相关；5－HIAA／HVA与思维形式障碍呈显著正相关。结论 精神分裂症患者存在中枢DA和5－HT相互作用的失平衡，这种失平衡与某些重要精神症状有关，且受性别因素的影响。

Study on interactions of central dopamine and serotonin and its gender-related differences in schizophrenic patients

Objectives: To study interactions and its gender-related difference of central dopamine (DA) and serotonin (5-HT) in schizophrenic patients. Method: The levels of DA, 5-HT and their metabolites (HVA, 5-HIAA) in CSF of 30 male patients, 37 female patients, 21 male normal controls and 9 female normal controls were determined by high performance liquid chromatography (HPLC). The ratios of 5-HT/DA, 5-HIAA/HVA were regarded as index of interaction between central DA and 5-HT. Results: The differences in ratio of 5-HT/DA, 5-HIAA/HVA among 4 groups (male patients, femle patients, male normals, female normals) were found (F = 3. 567, P = 0.032; F=12. 464, P = 0. 000). 5-HIAA/HVA ratio of male, female schizophrenics and male normal controls were significantly lower than that of female normal controls. Among male patients, ratio of 5-HT/DA was correlated negatively with BPRS and its positive symptom, ratio of 5-HIAA/HVA was correlated negatively with hallucination, but positively with formal thought disorder. Among female patints, ratio of 5-HT/DA was correlated negatively with affective blunting, but positively with non-special symptom, ration of 5-HIAA/HVA was correlated positively with formal thought disorder. Conclusion: Schizophrenia was characterized by imbalance on interaction between central DA and 5-HT, in which its relationship to important symptom and gender were found.