【摘要】 目的 探讨强迫症患者应用氯米帕明治疗前后脑脊液中5-羟色胺、5-羟吲哚乙酸表达水平的变化,分析临床疗效与5-羟色胺、5-羟吲哚乙酸表达水平的关系。方法 对36例强迫症患者予以口服氯米帕明治疗,观察12周。治疗前后采用耶鲁-布朗强迫量表评定临床疗效,检测脑脊液中5-羟色胺、5-羟吲哚乙酸表达水平,并进行相关分析。结果 本组患者治疗后耶鲁-布朗强迫量表总分较治疗前显著下降(P<0.01),治疗12周末有效率为57.6%(19/33)。有效患者治疗前脑脊液中5-羟吲哚乙酸表达水平显著高于无效患者(P<0.05)。有效患者治疗后脑脊液中5-羟吲哚乙酸表达水平较治疗前显著下降(P<0.05),5-羟色胺表达水平与治疗前比较差异无显著性(P>0.05)。有效患者耶鲁-布朗强迫量表总分减分率与脑脊液中5-羟吲哚乙酸表的变化值呈正相关(r=0.62,P<0.01),与5-羟色胺变化值无相关性。结论 强迫症患者经氯米帕明治疗后其脑脊液中5-羟吲哚乙酸表达水平下降,其表达水平下降与疗效呈正相关。脑脊液中5-羟吲哚乙酸表达水平可能是判断强迫症患者疗效的一个重要指标,其敏感性优于5-羟色胺。更多还原

【Abstract】 Objective To explore the changes of expression level of CSF 5-HT and 5-HIAA of OCD patients before and after clomipramine treatment and analyze the relationship between curative effect and the expression level of 5-HT and 5-HIAA.Methods Thirty-six OCD patients were treated with oral clomipramine for 12 weeks.Before and after treatment efficacies were assessed with the Yale-Brown ObsessiveCompulsive Scale(Y-BOCS),expression levels of CSF 5-HT and 5-HIAA detected,and correlation analyses carried out.Results After treatment the total score of the Y-BOCS lowered more significantly compared with pretreatment(P<0.01),at the end of the 12 th week effective rate was 57.6%(19/33).Before treatment 5-HIAA expression level was significantly higher in patients whose treatment were effective than ones ineffective(P<0.05).After treatment 5-HIAA expression level lowered more significantly compared with pretreatment in patients whose treatment were effective(P<0.05),there was no significant difference in 5-HT(P>0.05).The reducing score rate of the Y-BOCS total score was positively related to the change value of CSF 5-HIAA expression level in patients whose treatment were effective(r=0.62,P<0.01) and had no correlation to 5-HT.Conclusion CSF 5-HIAA expression levels of OCD patients lower after clomipramine treatment,the drop of 5-HIAA expression levels is positively related to curative effect.CSR 5-HIAA expression level may be an important index judging curative effect of OCD patient and its sensitivity is higher compared with 5-HT.更多还原