抑郁症单胺类递质受体研究进展

目前认为,抑郁症的发病主要与单胺类递质有关,单胺类递质受体系统在抑郁症的发病及治疗过程中会发生明显变化,本文综述了5-羟色胺受体,肾上腺素受体和多巴胺受体在抑郁症发病机制中所起作用的研究进展。     

难治性抑郁症治疗前后血浆单胺类神经递质代谢产物的变化

目的：探讨难治性抑郁症患者抗抑郁剂治疗前后的单胺类神经递质代谢产物的改变。方法：随机入组30例难治性抑郁症患者,进行汉密尔顿抑郁量表（HAMD）的临床评定。用酶联免疫吸附方法对这30例患者进行5-HIAA,MHPG检测,并与随机选取的经汉密尔顿抑郁量表（HAMD）临床评定的30名普通抑郁症患者进行比较。综合治疗8周后对难治性抑郁症患者进行治疗前后对比。结果：难治性抑郁症组治疗前血浆5-HIAA,MHPG浓度低于普通对照组（p〈0.05）,经5-羟色胺重摄取抑制剂治疗的难治性抑郁症患者,5-HIAA和MHPG含量与治疗前比较均有所升高,差异有显著性（p〈0.05）;结论：难治性抑郁症患者存在中枢5-羟色胺和去甲肾上腺素功能低下;个体化合理使用SSRIs类药物辅以心理治疗能有效地提高难治性抑郁症患者的外周单胺类递质水平,减轻患者的抑郁程度。     

难治性抑郁症治疗前后血浆单胺类神经递质代谢产物的变化

目的:探讨难治性抑郁症患者抗抑郁剂治疗前后的单胺类神经递质代谢产物的改变。方法:随机入组30例难治性抑郁症患者,进行汉密尔顿抑郁量表(HAMD)的临床评定。用酶联免疫吸附方法对这30例患者进行5-HIAA,MHPG检测,并与随机选取的经汉密尔顿抑郁量表(HAMD)临床评定的30名普通抑郁症患者进行比较。综合治疗8周后对难治性抑郁症患者进行治疗前后对比。结果:难治性抑郁症组治疗前血浆5-HIAA,MHPG浓度低于普通对照组(p<0.05),经5-羟色胺重摄取抑制剂治疗的难治性抑郁症患者,5-HIAA和MHPG含量与治疗前比较均有所升高,差异有显著性(p<0.05);结论:难治性抑郁症患者存在中枢5-羟色胺和去甲肾上腺素功能低下;个体化合理使用SSRIs类药物辅以心理治疗能有效地提高难治性抑郁症患者的外周单胺类递质水平,减轻患者的抑郁程度。     

调心滋肾中药组方对老年痴呆大鼠海马神经递质的影响

目的: 建立痴呆大鼠模型,观察调心滋肾中药组方对大鼠海马神经递质含量的影响.方法: 选用体重300～350 g的健康成年雄性Wistar大鼠, 参照大鼠脑立体定位图谱,双侧注入Ibotenic acid(IA)破坏大鼠Meynert基底核,建立痴呆大鼠模型.造模7 d后应用调心方、滋肾方和调心滋肾方治疗各20 d后,分光光度法检测海马乙酰胆碱含量,高效液相色谱法检测5-羟色胺和去甲肾上腺素的含量.结果: 经调心方、滋肾方和调心滋肾方治疗后,痴呆模型大鼠海马乙酰胆碱、5-羟色胺和去甲肾上腺素含量均明显提高.结论: 经调心方、滋肾方和调心滋肾方对痴呆模型大鼠海马降低的乙酰胆碱、5-羟色胺和去甲肾上腺素有上调作用.     

人参茎叶皂甙对大鼠垂体催乳素分泌的影响及其机制的探讨

本实验观察了人参茎叶皂甙(GSLS)对雄性大鼠血浆催乳素水平、垂体催乳素细胞超微结构和下丘脑中枢神经递质的影响。结果表明:5～100mg/kg的GSLS可刺激催乳素的释放,剂量加大反而无效;GSLS还可拮抗急性饥饿所致的大鼠垂体催乳素细胞超微结构的损伤;GSLS能分别使大鼠下丘脑中多巴胺和5-羟色胺含量增高和降低。结果表明,GSLS有刺激垂体催乳素分泌的作用,其机制可能与其直接作用于垂体细胞和/或经下丘脑中多巴胺和5-羟色胺含量的变化有关。     

儿童强迫症、抑郁症患者血小板5-羟色胺浓度的比较研究

目的:通过检测儿童强迫症、抑郁症患者血小板5-羟色胺(5-HT)的浓度,探讨血小板5-HT在儿童强迫症、抑郁症发病中的作用.方法:采用高效液相色谱法检测22例强迫症患儿(包括强迫思维15例,强迫动作7例)和20例抑郁症惠儿血小板5-HT的浓度,并与20名正常儿童进行比较.结果:强迫症患儿(173.43±90.67)ng/109和抑郁症患儿(251.62±152.72)ng/109血小板5-HT的浓度低于正常儿童(351.91±170.97)ng/109(P<0.05),强迫症患儿的血小板5-HT的浓度和抑郁症惠儿的差异没有显著性(P>0.05).强迫症患儿中,强迫思维惠儿的血小板5-HT的浓度(147.09±44.92)ng/109低于强迫动作患儿(229.88±1:136.44)ng/109(P<0.05).结论:儿童强迫症、抑郁症患者血小板5-HT浓度明显下降,并且强迫思维患儿的血小板5-HT浓度与强迫动作患儿的差异有显著性.     

家兔第四脑室内给予几种递质对膈神经放电高频振荡的影响

于65只清醒麻痹、迷走神经切断的家兔,观察第四脑室内注射中枢递质和受体阻断剂对膈神经放电高频振荡频率的影响。去甲肾上腺素、5-羟色胺、多巴胺、乙酰胆碱或γ-氨基丁酸,可使高频振荡频率下降。酚妥拉明、氟哌啶醇或麦角酰二乙胺对高频振荡频率无明显影响,而肉桂硫胺、东莨菪碱或印防已毒素可使高频振荡频率加快。结果提示,内源性5-羟色胺、乙酰胆硷和γ-氨基丁酸可能参与呼吸的调节。     

帕罗西汀治疗阿尔兹海默症合并抑郁对血清NE以及5-HT表达的影响

摘要 目的：探讨帕罗西汀治疗阿尔兹海默症合并抑郁对血清去甲肾上腺素(Noradrenaline,NE)以及5-羟色胺(5-hydroxytryptamine,5-HT)表达的影响。方法：2017年9月到2019年8月选择在本院诊治的98例阿兹尔海默症合并抑郁患者,根据治疗方法的不同分为帕罗西汀组50例与多奈哌齐组48例。多奈哌齐组给予多奈哌齐治疗,帕罗西汀组在多奈哌齐组治疗的基础上给予帕罗西汀治疗,两组治疗观察3个月,记录血清NE、5-HT表达变化情况。结果：帕罗西汀组的总有效率是96.0 % (48/50),显著高于多奈哌齐组的79.2 % (38/48) (P<0.05)。两组治疗前的MMSE评分对差异比无统计学意义(P<0.05),两组治疗后的MMSE评分显著高于治疗前(P<0.05),且帕罗西汀组也显著高于多奈哌齐组(P<0.05)。帕罗西汀组治疗期间的便秘、嗜睡、头晕、心动过速、肝功能异常等不良反应发生率为40.0 % (20/50),多奈哌齐组为31.3 % (15/48),两组对比差异无统计学意义(P>0.05)。两组治疗前血清NE、5-HT含量对比差异无统计学意义(P>0.05);两组治疗后的血清NE、5-HT含量显著高于治疗前(P<0.05),且帕罗西汀组也显著高于多奈哌齐组(P<0.05)。结论：帕罗西汀治疗阿尔兹海默症合并抑郁能促进血清NE、5-HT的释放,改善患者的认知功能,提高治疗效果确切,且不会增加不良反应。     

奥氮平联合氟西汀治疗对抑郁症患者血清NE水平以及抑郁情绪影响的临床研究

摘要 目的：研究奥氮平联合氟西汀治疗抑郁症患者的临床疗效,并探讨联合治疗对抑郁症患者血清去甲肾上腺素（Norepinephrine,NE）和抑郁情绪的影响。方法：纳入2018年6月到2020年5月在我院接受治疗的抑郁症患者56例,随机数表法将其分为对照组和研究组两组。对照组患者接受氟西汀治疗,而研究组患者接受奥氮平联合氟西汀治疗,两组患者均治疗8周。比较两组患者年龄、性别、身高、BMI以及病程等一般资料,并比较两组患者临床治疗疗效、治疗期间不良反应发生率、治疗前后血清NE水平。用汉密顿抑郁量表(Hamilton Rating Scale for Depression,HAMD)和抑郁自评量表（Self-Rating Depression Scale,SDS）评估两组患者抑郁情绪。结果：两组患者性别、年龄、身高、BMI、病程以及合并症等一般情况均显示无显著差异（P>0.05）。研究组治疗总有效率（92.86%）显著高于对照组（64.29%）总治疗有效率（P<0.05）,但研究组患者治疗期间不良发生率（32.14%）与对照组（28.57%）比较无显著差异（P>0.05）。治疗后,两组患者血清NE水平均较治疗前显著升高（P<0.05）,并且研究组患者治疗后血清NE水平均显著高于对照组患者（P<0.05）;两组患者血清HAMD和SDS评分均较治疗前显著降低（P<0.05）,并且研究组患者治疗后HAMD和SDS评分均显著低于对照组患者（P<0.05）。结论：奥氮平联合氟西汀治疗抑郁症患者安全有效,不良反应发生率较低,可有效升高抑郁症患者血清NE水平,而改善患者抑郁情绪。     

逍遥散对慢性心力衰竭合并抑郁患者心功能、炎症介质和血清5-HT、NE、CORT的影响

摘要 目的：探讨逍遥散对慢性心力衰竭（CHF）合并抑郁患者心功能、炎症介质和血清5-羟色胺（5-HT）、去甲肾上腺素（NE）、皮质醇（CORT）的影响。方法：选择我院于2017年10月至2018年12月收治的94例CHF合并抑郁患者,随机分为对照组、观察组,每组47例,对照组给予常规CHF治疗及盐酸帕罗西汀治疗,研究组给予常规CHF治疗及逍遥散治疗,比较两组疗效、心功能、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、5-HT、NE、CORT、明尼苏达心衰生活质量调查表（MLHFQ）、汉密尔顿抑郁量表（HAMD）及不良反应。结果：观察组治疗8周后的CHF总有效率、抑郁总有效率为82.98%、87.23%,高于对照组的63.83%、61.70%（P<0.05）。治疗8周后,两组MLHFQ、HAMD评分均较治疗前下降,且观察组低于对照组（P<0.05）。与治疗前相比,治疗8周后,两组CORT、IL-6、TNF-α下降,且观察组低于对照组（P<0.05）, 5-HT、NE升高,且观察组高于对照组（P<0.05）。两组与治疗前相比,治疗8周后,两组LVSD、LVED下降,且观察组低于对照组（P<0.05）,LVEF升高,且观察组高于对照组（P<0.05）。治疗期间,两组未出现严重不良反应。结论：逍遥散治疗CHF合并抑郁患者,疗效肯定,可有效改善患者心功能,减轻炎性反应,并调节血清5-HT、NE、CORT水平。     

半导体激光对机体中枢神经递质影响的初步观察

本工作报道了血管内照射（６５０ｎｍ,５ｍＷ,ｃｗ）对家兔尾核、下丘脑ＤＡ和ＮＥ的影响,发现ＤＡ在尾核和下丘脑中均有下降现象,但均Ｐ＞０．０５。在大鼠光照“扶突”穴中亦发现ＤＡ在脑干和尾核中,亦有下降倾向,ＮＥ有脑干和尾核中则有上升倾向。５—ＨＴ则均下降,但亦均未达显著性差异,（Ｐ＞０．０５）。另发现在人体血管内照射时,血液中ＮＯ·含量随照射次数增加而递减倾向。这些变化作者认为与光照的光化学反应引发的神经体液性调控有关。在本工作中还发现光照后神经未梢中的线粒体有肿胀现象。     

舒肝解郁胶囊联合阿戈美拉汀对抑郁症患者血清单胺类神经递质和神经功能相关因子的影响

摘要 目的：观察舒肝解郁胶囊联合阿戈美拉汀治疗抑郁症的疗效及对血清单胺类神经递质和神经功能相关因子的影响。方法：纳入我院2017年5月~2020年5月接诊的120例抑郁症患者,经双色球随机分组法将患者分为对照组和观察组,各为60例。对照组患者予以阿戈美拉汀治疗,观察组患者予以舒肝解郁胶囊联合阿戈美拉汀治疗。比较两组疗效、血清单胺类神经递质、神经功能相关因子、抑郁焦虑评分及不良反应发生率。结果：观察组的临床总有效率为93.33%（56/60）,高于对照组的73.33%（44/60）（P<0.05）。两组治疗6周后汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评分较治疗前降低,且观察组较对照组低（P<0.05）。两组治疗6周后多巴胺（DA）、去甲肾上腺素（NE）、5-羟色胺（5-HT）水平较治疗前升高,且观察组高于对照组（P<0.05）。两组治疗6周后S100?茁、髓磷脂碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）水平较治疗前降低,且观察组低于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：舒肝解郁胶囊联合阿戈美拉汀治疗抑郁症,疗效显著,可有效调节血清单胺类神经递质和神经功能,改善抑郁症状,且安全可靠。     

Neurophysiological study on possible protective and therapeutic effects of Sidr (Zizyphus spina-christi L.) leaf extract in male albino rats treated with pentylenetetrazol

In this study, anti-convulsant effect of Sidr leaf extract was examined by using pentylenetetrazol (PTZ) model on male albino rat by evaluating the changes in norepinephrine (NE), dopamine (DA) and serotonin (5-HT) contents in different brain regions (cerebellum, brainstem, striatum, cerebral cortex, hypothalamus and hippocampus). The administration of subconvulsive dose of PTZ (40 mg/kg i.p.) every other day for 9 days caused a significant decrease in monoamine content in different brain areas, this is may be due to the increase in nitric oxide levels, although antagonized the GABAA receptors which led to neurotransmitter release so the content is decreased. Administration of PTZ after treatment with Sidr (50 mg/kg i.p.) leaf extract for 3 weeks as a protective group and administration of Sidr leaf extract for 3 weeks after treatment of PTZ as a therapeutic group caused significant increase in NE, DA, and 5-HT contents in all tested brain regions at most of the time intervals studied. This may be due to the presence of peptide and cyclopeptide alkaloids in the extract which inhibit neurotransmitter activity which led to the inhibition of neurotransmitter release. From these results, we can say that the Sidr leaf extract has neuroprotective and therapeutic roles against pentylenetetrazol convulsant effect.     

Effect of chronic administration of phenytoin on regional monoamine levels in rat brain

Phenytoin (DPH) is a widely used anticonvulsant drug but a conclusive mode of action is not yet clear. This study was undertaken to assess the effects of chronic administration of DPH on monoamine levels. DPH (50 mg/kg body weight) was administered to adult male Wistar rats by intraperitoneal injections for 45 days and the regional brain levels of norepinephrine (NE), dopamine (DA) and serotonin (5-HT) were assayed using high performance liquid chromatographic (HPLC) method. The experimental rats revealed no behavioral deficits of any kind nor body and brain weight deficits were observed. Increased NE levels were observed after DPH administration in motor cortex (P<0.05), striatum-accumbens (P<0.01) and hippocampus (P<0.01), whereas, NE level was decreased in brain stem (P<0.05). DA levels were increased in striatum-accumbens (P<0.05), hypothalamus (P<0.001) and cerebellum (P<0.001) but decreased in brainstem (P<0.01). In DPH treated rats, 5-HT levels were increased in motor cortex (P<0.001) but decreased in cerebellum (P<0.001) when compared to control group of rats. The present study suggest that chronic administration of DPH induces alterations in monoamine levels in specific brain regions. DPH seems to mediate, its anticonvulsant action by selectively altering the monoamine levels in different brain regions.     

老年肺癌患者化疗期间抑郁情况调查及相关因素分析

目的:调查老年肺癌患者化疗期间抑郁情况及分析其相关因素。方法:选取2012年1月至2016年12月在我院化疗的老年肺癌患者300例,调查统计患者的基本信息资料,采用Zung氏自评抑郁量表(SDS)评价患者的抑郁情况,统计患者抑郁情况的调查结果,并采用Logistic回归分析影响老年肺癌患者抑郁的相关因素。结果:300例老年肺癌的患者当中,在化疗期间有抑郁者164例,占54.67%。其中59例是轻度抑郁,占35.98%;90例是中度抑郁,占54.88%;15例是重度抑郁,占9.15%。单因素分析显示,老年肺癌患者抑郁发生率与年龄、收入水平、TNM分期及有无癌症转移有关(均P0.05),与性别、文化程度、癌症分型无关(P0.05)。多因素Logistic回归分析显示影响老年肺癌患者抑郁的相关因素有年龄≥70岁、收入水平3000元/月、TNM分期为Ⅲ~Ⅳ期以及癌症转移(P0.05)。结论:老年肺癌患者在化疗期间较容易出现抑郁症状,临床上应加以重视,年龄≥70岁、收入水平3000元/月、TNM分期为Ⅲ~Ⅳ期以及癌症转移是影响老年肺癌患者抑郁的相关因素,针对相关因素应尽早采取相应的干预措施,从而有利于改善患者的负性心理情绪。     

Hyperglycemic responses to cold shock in the freshwater giant prawn, Macrobrachium rosenbergii

Crustacean hyperglycemic hormone (CHH), a neurohormone synthesized and released from the x-organ sinus gland complex, is primarily involved in carbohydrate metabolism; biogenic amines and peptidergic neuroregulators are known to modulate the release of CHH. Marked elevations of hemolymph glucose titers, which peaked within 2 h, were observed in both intact and bilaterally eyestalk-ablated prawns, Macrobrachium rosenbergii, when they were transferred directly from their optimal temperature of 28 °C to lower temperatures close to their lethal limit. Hyperglycemia can therefore be considered a characteristic response in this species under cold shock. Involvement of biogenic amines in the hyperglycemic response was also demonstrated. Hyperglycemic effects of epinephrine, dopamine and serotonin were mediated through CHH at the eyestalk level, but the response under cold shock was not exclusively mediated through CHH. It is suggested that factor(s) other than CHH are involved in the hyperglycemic response, possibly norepinephrine or/and octopamine. Accepted: 24 October 1998     

Monoamine Oxidase Activity and Monoamine Metabolism in Brains of Parkinsonian Patients Treated with l-Deprenyl

Monoamine oxidase (MAO) type A and type B were measured using kynuramine, 3,4-dihydroxyphenylethylamine (dopamine, DA), and 5-hydroxytryptamine (5-HT, serotonin) in 20 brain areas. The highest activities were found in the striatum (caudate nucleus, putamen, globus pallidus, and substantia nigra), hypothalamus, and c-mammilare. The ratio of DA to 5-HT deamination varied in the different regions, being in favor of DA in the striatum. With kynuramine as the substrate IC50 values of a number of inhibitors indicated that l-deprenyl was far more potent an inhibitor of human brain MAO than clorgyline or harmaline. N-Desmethylpropargylindane hydrochloride (AGN 1135) was also shown to have MAO-B inhibitory selectivity similar to that of l-deprenyl. Brains obtained at autopsy from l-deprenyl-treated Parkinsonian patients showed that, whereas MAO-B was fully inhibited by the therapeutic doses of l-deprenyl, substantial MAO-A activity was still evident. These results are matched by the significant increases of DA noted in caudate nucleus, globus pallidus, putamen, and substantia nigra and the unaltered 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in the same regions. These data indicate that the therapeutic actions of l-deprenyl may lie in its selective inhibition of MAO-B resulting in increased brain levels of DA formed from L-dihydroxyphenylacetic acid (L-DOPA).     

化疗期乳腺癌患者情绪状态及其影响因素的调查研究

目的:调查化疗期乳腺癌患者的抑郁及焦虑情绪状态,探讨情绪状态的影响因素,促使医护人员更好的了解化疗期乳腺癌患者的情绪状态,以便更好的提供相应的护理与治疗。方法:采用自行设计的调查问卷,对2012年7~12月住院的97名化疗期乳腺癌患者进行调查,内容包括一般人口学资料、医院焦虑抑郁量表及状态-特质焦虑问卷。结果:化疗期乳腺癌患者的抑郁得分为(4.79±4.23)分,特质焦虑得分为(41.70±11.81)分,状态焦虑得分为(40.61±12.11)分,其影响因素包括教育水平和家庭人均月收入,Pearson相关分析得出特质焦虑、状态焦虑与抑郁之间存在正相关。结论:化疗期乳腺癌患者焦虑与抑郁处于较高水平,教育水平越高、家庭人均月收入越高的患者其焦虑、抑郁程度越低。医护人员可以通过对化疗期乳腺癌患者进行相应的心理疏导以减轻负性情绪的产生,以促进和保持治疗的顺利进行与疾病的转归。     

Neurotransmitters regulate rhythmic size changes amongst cells in the fly's optic lobe

Axon calibre in monopolar cells L1 and L2 of the fly's lamina can change dynamically. Swelling by day, L2 exhibits a daily rhythm of changing size apparntly mediated by wide-field LBO5HT and PDH cells. L1/L2 axon profiles were measured planimetrically in the housefly, Musca domestica, from 1 m cross sections. Four hours after injecting 80–100 nl of 1.25 × 10^–4 M 5-HT into the optic lobe, L1's axon swelled but L2's did not, whereas 2.2 × 10^–5 M of PDH enlarged both axons. Similar to 5-HT, 1.63 × 10^–4 M histamine (the photoreceptor transmitter) enlarged L1 but not L2, mimicking light exposure, while 1.7 × 10^–4 M glutamate and 1.94 × 10^–4 M GABA both decreased L1 and L2. 2.5 × 10^–4 M of 5,7-dihydroxytryptamine decreased L2 and, somewhat, L1, an effect attributable to the loss of LBO5HT neurites. Twenty four hours after cutting LBO5HT and PDH commissural pathways, L1 and L2 both shrank. Apparently, L2's size depends on either LBO5HT or sufficient 5-HT, and L1 and L2 have different response ranges to 5-HT. Responses to PDH imply that daytime PDH release drives a circadian rhythm, enlarging L1 and L2.Abbreviations ERG electroretinogram - GABA -aminobutyric acid - PDH pigment-dispersing hormone - PDF pigment-dispersing factor - 5-HT 5-hydroxytryptamine - EM electron microscopy(ic)     

110例绝经后子宫出血相关因素分析

目的:探讨绝经后子宫出血的年龄、绝经年限、子宫内膜厚度与疾病的关系,以及相关因素分析。方法:回顾分析2003～2005诊治的110例自然绝经1年以上子宫再次出血者的诊刮或子宫切除的临床病理资料。结果:绝经后病理结果分别为非器质性病变44例占40%、良性病变26例占23.6%和恶性肿瘤(子宫内膜癌)40例占36.4%,相关影响因素有IUD 13例占11.8%、高血压22例占20%和肥胖17例占15.5%。结论:绝经后子宫出血的首要原因是子宫内膜非器质性病变,年龄越大、绝经年限越长、内膜越厚、恶性肿瘤发生率愈高,其中IUD、高血压、肥胖为影响因素。