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东京地铁沙林毒气中毒受害者的血清胆固醇、尿酸和胆碱酯酶:与创伤后应激障碍的关系

Serum cholesterol, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning: a relation with post-traumatic stress disorder.

作者信息

Tochigi Mamoru, Umekage Tadashi, Otani Toshiyuki, Kato Tadafumi, Iwanami Akira, Asukai Nozomu, Sasaki Tsukasa, Kato Nobumasa

机构信息

Department of Psychiatry, Haryugaoka Hospital, Fukushima, Japan.

出版信息

Neurosci Res. 2002 Nov;44(3):267-72. doi: 10.1016/s0168-0102(02)00146-3.

Abstract

Cholesterol and uric acid, which might correlate with steroidogenesis and monoamine functions, may change under emotionally stressful conditions and in mental disturbances. Among anxiety disorders, an increase of serum cholesterol has been observed in panic disorder. However, the issue has not been adequately investigated in other anxiety disorders, including post-traumatic stress disorder (PTSD). The present study investigated serum cholesterols, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning, 1995, in a series of 5-year follow-ups. Cholinesterase was studied, in relevance with serum lipid changes and symptoms of PTSD, and also in light of a biological effect of sarin. Out of 34 victims, eight developed PTSD and two were currently diagnosed with PTSD using the Clinician-Administered PTSD Scale (CAPS). No significant relationship was observed between PTSD and serum cholesterols or uric acid. Several factors including co-occurrence of other mental disturbances with PTSD, in addition to the limited sample size, might have affected the result. In contrast, serum cholinesterase level was significantly reduced in the victims with the development of PTSD, compared with the matched controls (P<0.02, t-test). This might partly reflect a long-term remnant effect of sarin intoxication, although an effect of the psychological experience could not be totally excluded.

摘要

胆固醇和尿酸可能与类固醇生成及单胺功能相关,在情绪应激状态和精神障碍时可能会发生变化。在焦虑症中,惊恐障碍患者血清胆固醇会升高。然而,包括创伤后应激障碍(PTSD)在内的其他焦虑症在这方面尚未得到充分研究。本研究对1995年东京地铁沙林毒气中毒受害者进行了一系列为期5年的随访,检测了他们的血清胆固醇、尿酸和胆碱酯酶。研究胆碱酯酶与血脂变化及PTSD症状的关系,同时也考虑了沙林的生物学效应。34名受害者中,8人患创伤后应激障碍,2人目前使用临床医生用创伤后应激障碍量表(CAPS)被诊断为创伤后应激障碍。未观察到创伤后应激障碍与血清胆固醇或尿酸之间存在显著关系。除样本量有限外,包括创伤后应激障碍与其他精神障碍共病在内的几个因素可能影响了结果。相比之下,与匹配的对照组相比,发生创伤后应激障碍的受害者血清胆碱酯酶水平显著降低(P<0.02,t检验)。这可能部分反映了沙林中毒的长期残留效应,尽管不能完全排除心理体验的影响。

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