首诊强迫症患者脑脊液与血浆单胺类神经递质的对照研究

Study on cerebro-spinal fluid and plasma monoamine neurotransmitters of obsessive-compulsive disorder diagnosed primarily

目的比较首诊强迫症患者与对照组脑脊液（CSF）和血浆5-羟色胺（5-HT）、5-羟吲哚-酸（5-HIAA）、高香草酸（HVA）等物质的含量，探讨单胺类神经递质在强迫症发病机制中的作用。方法对首次诊断为强迫症的患者和正常对照组分别采用库仑阵列电化学高效液相色谱检测法测定，比较CSF以及血浆中5-HT、5-HIAA、HVA等物质的含量。结果强迫症患者CSF中5-HT的含量[（37．03±9．32）μg/L]、血浆中5-HIAA的含量[（8．99±1．21）μg/L]显著低于对照组（P〈0．05）；强迫症患者的耶鲁一布朗强迫量表评分与其CSF中HVA的含量呈显著正相关（r=0．421，P〈0．05）。结论强迫症患者CSF中5-HT、血浆中5-HIAA的含量显著性低于对照组OCD存在5-HT功能不足；症状的严重程度与CSF中HVA的含量呈正相关。

Objective To compare cerebrospinal fluid （CSF） and plasma levels of serotonin（5-HT） ,5-hydroxyindoleacetic acid （ 5-HIAA ）, homovanillic acid （ HVA ）, norepinephrine （ NE ） and 3-methoxy-4-hydroxy-phenylglycol（MHPG） between patients with obsessive-compulsive disorder（OCD） diagnosed primarily, and the normal controls and to explore the role of monoamine neurotransmitters in the pathogenesis of OCD. Methods Levels of 5-HT,5-HIAA,HVA,NE, MHPG and other substances in CSF and plasma were assayed by high performance liquid chromatography with electrochemical detection on samples, samples of patients before treatment and the normal controls were measured in one assay. Results CSF levels of 5-HT（ 37.03±9. 32μg/L） and plasma levels of 5-HIAA （8.99±1.21μg/L） in patients with OCD were significantly lower than those of the normal controls （P〈0.05）. There was significant positive correlation between CSF levels of HVA and scores of Y-BOCS on OCD（r=0.421, P〈0.05）, but there was no correlation between scores of Y-BOCS on OCD and other neuro-transmitters levels. Conclusion CSF levels of 5-HT and plasma levels of 5-HIAA in patients with OCD were significantly lower than those of the normal controls. Patients with OCD showed poor 5-HT function, severity of OCD symptoms was positively correlated with CSF levels of HVA.