惊恐障碍一氧化氮、一氧化氮合酶及脑血流研究

Serum Nitric Oxide,Nitric Oxide Synthase Level and Cerebral Blood Flow in Panic Disorder

目的 :研究惊恐障碍 (PD)一氧化氮、一氧化氮合酶及脑血流的改变以及影响这些改变的相关因素。方法 :研究组为 3 0例PD组 ,对照组为 3 0例广泛焦虑障碍 (GAD) +PD组 ,3 0例GAD组及 2 2例正常对照 (NC)组。所有样本均测一氧化氮 (NO)、一氧化氮合酶 (NOS)及脑血流量。比较PD组分别与GAD +PD组、GAD组及正常对照 (NC)组之间的差别 ,并在PD组内部对有关指标作多元逐步回归分析。结果 :PD组NO浓度较GAD组低 (67 2 2± 3 9 62 ,10 2 8± 60 69)。NOS测重浓度PD组与其他各组无显著性差异 (P >0 0 5 )。脑血流测定 ,PD组左侧大脑中动脉收缩峰、右侧大脑中动脉收缩峰及右侧大脑中动脉平均峰较NC组低且差异有显著性。右侧椎动脉收缩峰较GAD组及NC组低。PD组NO浓度与HAMA负相关。左侧大脑中动脉收缩峰与左侧大脑中动脉平均峰、右侧大脑中动脉收缩峰及精神性焦虑呈正相关 ,与右侧大脑中动脉平均峰及右侧大脑前动脉收缩峰、年龄及女性呈负相关。右侧大脑中动脉收缩峰与右侧大脑中动脉平均峰、右侧大脑前动脉收缩峰呈正相关 ,与右侧大脑前动脉平均峰呈负相关。右侧大脑中动脉平均峰与右侧大脑中动脉收缩峰、左侧大脑中动脉平均峰、右侧大脑前动脉平均峰及NO呈正相关 ,与年龄、左侧大脑中动脉收缩峰及右侧大脑前动?

Objective:To investigate the change and related factors of nitric oxide,nitric oxide synthase level and cerebral blood flow(CBF) in panic disorder.Methods:30 patients with panic disorder,30 patients with generalized anxiety disorder and 22 normal controls entered the study.Serum level of NO and NOS were assayed.Cerebral blood flow were measured with TCD.Results:The concentration of NO was significantly lower in panic disorder group in comparison with GAD group.There was no significant difference in NOS level between panic disorder group and the control group.Cerebral blood peak flow velocity in the left and right middle cerebral artery and mean cerebral blood flow velocity in the right middle cerebral artery were lower than normal control group and the difference were very significant.Cerebral blood peak flow velocity in the right vertebral artery was lower than those of GAD and NC group.The concentration of NO in panic disorder was correlated with HAMA score negatively.Cerebral blood peak flow velocity in the left middle cerebral artery was correlated with mean Cerebral blood flow velocity in the left middle cerebral artery,peak CBF velocity in the right middle cerebral artery and psychological anxiety positively and correlated to cerebral blood peak mean velocity in the right middle cerebral artery,peak CBF velocity in the right anterior cerebral artery,age and female negatively.Cerebral blood peak flow velocity in the right middle cerebral artery has positive correlation with mean cerebral blood flow velocity in the right middle cerebral artery and peak CBF locity in the right anterior cerebral artery and negative correlation with cerebral blood mean flow velocity in the right anterior cerebral artery. Mean cerebral blood flow velocity in the right middle cerebral artery was correlated to cerebral blood peak flow velocity in the right middle cerebral artery,mean cerebral blood flow velocity in the left middle cerebral artery,cerebral blood mean flow velocity in the right anterior cerebral artery and NO level positively and age,cerebral blood peak flow velocity in the left middle cerebral artery and cerebral blood peak flow velocity in the right anterior cerebral artery negatively.Cerebral blood peak flow velocity in the right vertebra artery has positive correlation with cerebral blood mean flow velocity in the right vertebra artery and cerebral blood mean flow velocity in the left middle cercbral artery and negative correlation with cerebral blood peak flow velocity in the left anterior cerebral artery and cerebral blood mean flow velocity in the right anterior cerebral artery.Conclusion:The change of NO and cerebral blood flow may be one of the neurobiological mechanisms in panic disorder.To assay the level of NO and measure cerebral blood flow might become approach of diagnosis for panic disorder.