强迫症血小板5羟色胺含量与临床特征和氯丙咪嗪治疗的关系

The platelet 5-HT content in patients with OCD and its relation to clinical characteristics and clomipamine treatment.

目的 探讨强迫症的血清素功能与临床特征和药物治疗的关系。方法 采用临床评分与血小板敏感膜电极标准加入法测定 40例强迫症患者治疗前后的血小板 5 HT含量并与 3 0例健康人对照。结果 治疗前强迫症组与对照组血小板 5 HT含量的平均值分别为 (1 962 2± 982 3 ,90 9 0± 3 78 9)ng/1 0 9个血小板 ,强迫观念 ,强迫行为 ,合并抽动障碍的强迫症治疗前血小板 5 HT含量平均值分别是 (2 687 3± 442 5,2 0 49 9± 1 1 1 4 5,1 0 60 3± 54 3 6)ng/1 0 9个血小板 ,8周的氯丙咪嗪治疗后 ,强迫观念组血小板 5 HT含量下降到 83 3 1 2ng/1 0 9个血小板并伴良好疗效 ,合并抽动障碍的强迫症血小板 5 HT含量与治疗前比较无明显改变 ,对氯丙咪嗪的治疗反应也差。结论 不同症状特征的强迫症血清素功能的改变并不相同 ,对氯丙咪嗪的治疗反应与治疗前血小板 5 HT含量有关 ,本研究提示强迫症可能存在生化上的异源性 。

Objective This study is to explore serotonergic function and its relation to clinical characteristics and clomipramine treatment efficacy in the patients with obsessive compulsive disorder (OCD). Methods The clinical assessment and the standard addition method by coated carbon 5 HT sensing membrane electrode based on neutral carrier were used to measure the platelet 5 HT content of pretreatment in the 40 patients with OCD and compared to 30 healthy subjects. Results The pretreatment platelet 5 HT contents of patients with OCD and the control were 1962 2±982 3, 909 0±378 9 ng/10 9 platelet, respectively. The platelet 5 HT contents of obsession group, compulsion group and OCD with tic were 2687 3±442 5, 2049 9±1114 5 and 1060 3±543 6 ng/10 9 platelet, respectively. The platelet 5 HT content of obsession group returned to the baseline after 8 weeks clomipramine treatment and good effect, but those of OCD with tic showed no change and was associated with poor response to clomipramine. Conclusions OCD with different clinical characteristics have different serotonergic function profiles. The response to clomiparamine was related to the platelet 5 HT content of pretreatment. It was suggested that there might be biochemical heterogeneity in the patients with OCD, which could be the biochemical bases of different responses to clomipramine.