Wahlbeck K, Ahokas A, Nikkilä H, Miettinen K, Rimón R
Department of Psychiatry, University of Helsinki, Lappviksvägen, Finland.
Schizophr Res. 2000 Jan 21;41(2):335-40. doi: 10.1016/s0920-9964(99)00059-6.
The aim of the study was to evaluate a possible progression with time of cerebrospinal fluid (CSF) angiotensin-converting enzyme (ACE) levels in treated schizophrenia patients. CSF ACE was determined in duplicate by a sensitive inhibitor-binding assay (IBA) from morning CSF samples of 56 acute and chronic in-patients with schizophrenic psychoses diagnosed according to DSM-IV. CSF ACE correlated significantly with length of schizophrenic psychosis (r=0.39, p=0.003). There was also a positive significant correlation between CSF ACE and duration of current psychotic episode (r=0.39, p=0.003) as well as duration of current hospitalization (r=0.66, p<0.001). These significances were maintained even when patients who were not treated with antipsychotics at the time of sampling were excluded. The correlations also remained significant when controlling for current neuroleptic dose in chlorpromazine equivalents. Serum ACE did not correlate with any clinical variable. No significant correlations between serum or CSF ACE and age, diagnostic subgroup, gender, serum ACE, CSF to serum albumin ratios, or neuroleptic dose in chlorpromazine equivalents were detected. The elevation of CSF ACE seemed to be confined to a subgroup of chronic patients with few positive symptoms. Elevated CSF ACE may reflect an increased solubilization of ACE from cell membranes in the central nervous system or constitute an increased expression of the ACE gene in response to some stimuli. This may be a function of treatment or a result of the deteriorating schizophrenic process.
该研究的目的是评估接受治疗的精神分裂症患者脑脊液（CSF）中血管紧张素转换酶（ACE）水平随时间的可能变化。通过灵敏的抑制剂结合测定法（IBA）对56例根据DSM-IV诊断为精神分裂症精神病的急性和慢性住院患者早晨的脑脊液样本进行重复检测，以确定脑脊液ACE水平。脑脊液ACE与精神分裂症精神病的病程显著相关（r = 0.39，p = 0.003）。脑脊液ACE与当前精神病发作的持续时间（r = 0.39，p = 0.003）以及当前住院时间（r = 0.66，p < 0.001）之间也存在显著正相关。即使排除采样时未接受抗精神病药物治疗的患者，这些相关性仍然存在。在以氯丙嗪等效剂量控制当前抗精神病药物剂量时，相关性仍然显著。血清ACE与任何临床变量均无相关性。未检测到血清或脑脊液ACE与年龄、诊断亚组、性别、血清ACE、脑脊液与血清白蛋白比值或氯丙嗪等效剂量的抗精神病药物剂量之间存在显著相关性。脑脊液ACE的升高似乎仅限于阳性症状较少的慢性患者亚组。脑脊液ACE升高可能反映中枢神经系统中ACE从细胞膜的溶解增加，或者是对某些刺激的ACE基因表达增加。这可能是治疗的作用，也可能是精神分裂症病情恶化的结果。
