摘要
目的 探讨以阳性症状为主 (以下简称阳性 )或以阴性症状为主 (以下简称阴性 )的精神分裂症患者在氯氮平治疗前后脑脊液 (CSF)中高香草酸 (HVA)和 5 羟吲哚乙酸 (5 HIAA)浓度的动态变化。方法 对 2 8例阳性患者和 18例阴性患者进行 8周的氯氮平治疗。用高效液相色谱 电化学方法测定患者的HVA和 5 HIAA浓度。以精神分裂症阳性症状量表 (SAPS)和阴性症状量表 (SANS)为评定工具。以 12例非中枢神经系统疾病的肌病、周围神经炎患者为对照组。结果 治疗前阳性组HVA[(2 7± 2 0 )mg/L]高于对照组 [(10± 6 )mg/L]和阴性组 [(7± 6 )mg/L],P <0 0 1;阴性组 5 HIAA[(5± 4)mg/L]低于对照组 [(40± 19)mg/L]和阳性组 [(38± 47)mg/L],P <0 0 1。治疗后阴性组 5 HIAA[(8± 5 )mg/L]较治疗前增高 (P <0 0 5 ) ,SANS减分率与 5 HIAA的增高值之间呈显著正相关 (r =0 5 8,P <0 0 5 )。结论 阳性精神分裂症患者可能存在DA功能亢进 ,阴性精神分裂症患者可能有 5 羟色胺(5 HT)功能减退。阴性症状的改善与 5 HT功能的变化相关。
Objective A longitudinal study was conducted on CSF levels of HVA and 5 HIAA in baseline and post treatment of clozapine between positive and negative schizophrenia Methods The patients who met the Chinese Classification and Diagnostic Criteria for Mental Disorders, the Second Revised Edition for schizophrenia and Anderson′s positive and negative schizophrenic criteria, their CSF HVA and 5 HIAA concentration were determined by high performance liquid chromatography electro chemical device All patients were treated with clozapine for eight weeks and assessed by Scale for Assessment of Positive Symptoms and Scale for Assessment of Negative Symptoms(SANS) 28 positive and 18 negative patients were involved and compared with 12 peripheral nervous system diseases Results Baseline of HVA level in positive schizophrenia [(27±20) mg/L]was significantly higher than the controls [(10±6) mg/L] and negative schizophrenia [(7±6) mg/L], P <0 01 5 HIAA level in negative group [(5±4)mg/L] was significantly lower than the controls [(40±19) mg/L ] and positive group [(38±47) mg/L], P <0 01 Post treatment 5 HIAA level [(8±5)mg/L] was significantly increased than baseline in negative group ( P <0 05) Change of SANS score was significantly related with increasing of 5 HIAA ( r =0 58, P <0 05) Conclusions Positive schizophrenia has significant high HVA in CSF and hyperfunction of dopamine (DA) Negative schizophrenia has significant low 5 HIAA in CSF and hypofunction of 5 HT The improvement of negative symptoms is related with the change of 5 HT
出处
《中华精神科杂志》
CAS
CSCD
2000年第2期77-80,共4页
Chinese Journal of Psychiatry
基金
卫生部基金!资助项目 (96 1 1 32 )
