强迫症的神经内分泌研究

A study on neuroendocrine function in obsessive-compulsive disorder

为探讨强迫症患者的下丘脑-垂体-肾上腺皮质系统的功能状态及强迫症与抑郁症的生物学联系,作者对30例未服药的强迫症患者的基础血浆皮质醇、地塞米松抑制试验(DST)及氯丙咪嗪治疗前后的血催乳素含量进行测定,并以20例健康志愿者的血浆皮质醇、DST 和血催乳素测定值作对照。结果显示:强迫症患者基础血浆皮质醇和基础血催乳素含量均高于对照组,但 DST 无一例呈脱抑制反应;患者经氯丙咪嗪治疗后,血浆催乳素含量明显升高。结果提示,强迫症患者有神经内分泌方面异常,但 DST 未见脱抑制现象,不同于抑郁症。氯丙咪嗪的抗强迫症作用与该药对下丘脑5-羟色胺能神经元及多巴胺能神经元的影响有关。

As neurobiologica[ abnormalities could be found in the patients with obsessive-compulsive disorder,the neuroendocrine function in this disorder was investigated.The concentrations of basal plas- ma cortisol,plasma cortisol 17 hour after lmg dexamethasone oral administration (dexamethasone sup- pression test,DST),and plasma prolactin before and after clomipramine treatment in 30 patients with obsessive compulsive disorder were determined and compared with those in 20 healthy volunteers free from any drug treatment.The results showed that the basal plasma concentrations of cortisol and pro- lactin were higher in the patients group than in the control group.The non-supressive response case was found in neither group.The plasma prolactin after the patients treated with clomipramine was signifi- cantly elevated.Neuroendocrine abnormalities were found in the patients with obsessive-compulsive dis- order,but there was no case with non-supressive response,which was different from depressive disor- ders.The anti-obsessive effect of clomipramine may be related to its influence on the serotonergic and dopaminergic neurons in the hypothalamus.