Lee In-Soo, Kim Kyung-Jeong, Kang Eun-Ho, Yu Bum-Hee
Department of Psychiatry, Semin Mental Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Affect Disord. 2008 Sep;110(1-2):156-60. doi: 10.1016/j.jad.2007.12.007. Epub 2008 Jan 15.
Few studies have reported on the functional differences of the beta-adrenoceptor between treatment responders and non-responders in panic disorder (PD). The aim of this study was to compare the nature of the beta-adrenoceptor function and clinical variables between treatment responders and non-responders to paroxetine treatment in acute PD patients.
Paroxetine was administered to all of the panic patients for 12 weeks. The lymphocyte beta-adrenoceptor density (Bmax), affinity (1/Kd), and sensitivity (cAMP ratio) were measured in 22 untreated outpatients with acute PD and 22 age, sex and BMI matched control subjects. Psychological assessments were conducted using the HAM-A, and HAM-D, STAI-S and STAI-T, Anxiety sensitivity index (ASI), and Acute panic inventory (API).
A significantly higher Kd was observed in the panic patients before treatment as compared with the control subjects, but there was no significant difference in Kd between the panic patients and control subjects after the treatment. Among the 22 patients, the 11 treatment responders (50%) showed a significantly higher Kd and lower mean scores of HAM-D, STAI-S, STAI-T, and ASI at baseline, compared with the non-responders. Logistic regression revealed that the pretreatment Kd and HAM-D were significantly reliable predictors for treatment response (p<0.05).
The beta-adrenoceptor affinity (1/Kd) was decreased and adaptively normalized after treatment with paroxetine in the acute panic patients. In addition, a low pretreatment beta-adrenoceptor affinity (1/Kd) was found to predict the treatment response and can be suggested as a biological predictor of treatment response in acute PD.
很少有研究报道惊恐障碍（PD）治疗反应者与无反应者之间β-肾上腺素能受体的功能差异。本研究的目的是比较急性PD患者中帕罗西汀治疗反应者与无反应者之间β-肾上腺素能受体功能的性质和临床变量。
对所有惊恐患者给予帕罗西汀治疗12周。在22名未经治疗的急性PD门诊患者和22名年龄、性别及体重指数相匹配的对照受试者中测量淋巴细胞β-肾上腺素能受体密度（Bmax）、亲和力（1/Kd）和敏感性（cAMP比率）。使用汉密尔顿焦虑量表（HAM-A）、汉密尔顿抑郁量表（HAM-D）、状态-特质焦虑量表（STAI-S和STAI-T）、焦虑敏感性指数（ASI）和急性惊恐量表（API）进行心理评估。
与对照受试者相比，惊恐患者治疗前的Kd显著更高，但治疗后惊恐患者与对照受试者的Kd无显著差异。在22例患者中，11名治疗反应者（50%）在基线时的Kd显著更高，HAM-D、STAI-S、STAI-T和ASI的平均得分更低，与无反应者相比。逻辑回归显示，治疗前的Kd和HAM-D是治疗反应的显著可靠预测指标（p<0.05）。
急性惊恐患者用帕罗西汀治疗后，β-肾上腺素能受体亲和力（1/Kd）降低并适应性地恢复正常。此外，发现治疗前β-肾上腺素能受体亲和力低（1/Kd）可预测治疗反应，并可作为急性PD治疗反应的生物学预测指标。
