Stein M B, Uhde T W
Section on Anxiety and Affective Disorders, National Institute of Mental Health, Bethesda, Md 20892.
Arch Gen Psychiatry. 1991 Feb;48(2):148-56. doi: 10.1001/archpsyc.1991.01810260056009.
The effects of protirelin administration on the anterior pituitary release of thyrotropin and prolactin were examined in 26 patients with panic disorder and 22 healthy volunteers. There were no differences observed in hormonal responses to protirelin between patients and controls. However, higher Beck Depression Inventory scores were associated with smaller baseline-corrected maximal changes in thyrotropin responses. Cardiovascular responses to protirelin did not differ between a subgroup of 15 patients with panic disorder and 15 age- and sex-matched healthy controls. Although protirelin produced robust increases in heart rate and blood pressure, only one patient with panic disorder experienced a panic attack during the infusion. The hormonal findings suggest that the presence of depressive symptoms may have a significant impact on various indexes of neuroendocrine responsivity and should be taken into consideration when looking at biologic measures in patients with panic disorder. The cardiovascular and behavioral findings do not support the hypothesis that all panic-producing stimuli are nonspecific and suggest that the induction of physical stimuli may be insufficient to produce panic attacks even in susceptible individuals.
对26例惊恐障碍患者和22名健康志愿者进行了促甲状腺素释放素给药对垂体前叶促甲状腺激素和催乳素释放的影响研究。患者和对照组对促甲状腺素释放素的激素反应未观察到差异。然而，贝克抑郁量表得分较高与促甲状腺激素反应中经基线校正的最大变化较小有关。15例惊恐障碍患者亚组与15名年龄和性别匹配的健康对照之间对促甲状腺素释放素的心血管反应无差异。尽管促甲状腺素释放素使心率和血压显著升高，但在输注过程中只有1例惊恐障碍患者经历了惊恐发作。激素研究结果表明，抑郁症状的存在可能对神经内分泌反应性的各种指标有显著影响，在观察惊恐障碍患者的生物学指标时应予以考虑。心血管和行为研究结果不支持所有引发惊恐的刺激都是非特异性的这一假设，并表明即使在易感个体中，物理刺激的诱发可能不足以引发惊恐发作。
