Buckman T D, Kling A, Sutphin M S, Steinberg A, Eiduson S
Department of Neurology, Hahnemann University, Philadelphia, PA 19102-1192.
Psychiatry Res. 1990 Jan;31(1):1-14. doi: 10.1016/0165-1781(90)90103-c.
We have previously reported that the activity in platelets of the important antioxidant enzyme glutathione peroxidase (GPx) is inversely correlated with computed tomographic (CT) measures of brain atrophy in a population of patients with chronic schizophrenia, suggesting that low GPx may be a vulnerability factor in those schizophrenic patients with structural brain abnormalities. The significance of this finding has now been explored in a larger clinical population by examining the relation of GPx and CT parameters to psychosocial variables and to the activity of platelet monoamine oxidase (MAO), which has also been reported to be altered in certain schizophrenic populations. In the present study, low platelet GPx and high brain atrophy were found to be associated with DSM-III diagnoses of nonparanoid schizophrenia, a high degree of chronicity, and a predominance of negative symptoms. Contrary to some literature reports, atrophy also correlated with age and length of illness among the schizophrenic patients, although the contribution of these factors was less than that of low GPx, which was itself not age dependent. The ventricle-brain ratio (VBR) and atrophy were highly correlated in a control group of affective disorder patients, but not in the schizophrenic group, where large VBRs were found predominantly in the DSM-III undifferentiated subgroup. The low-GPx/high-atrophy schizophrenic patients had normal platelet MAO levels, and MAO was significantly lower only in the paranoid subgroup, consistent with reported observations. There was no evidence for a neuroleptic-induced effect on either enzyme.
我们之前曾报道,在一组慢性精神分裂症患者中,重要的抗氧化酶谷胱甘肽过氧化物酶(GPx)在血小板中的活性与脑萎缩的计算机断层扫描(CT)测量值呈负相关,这表明低GPx可能是那些存在脑结构异常的精神分裂症患者的一个易患因素。现在,通过研究GPx和CT参数与心理社会变量以及血小板单胺氧化酶(MAO)活性之间的关系,在更大的临床群体中探讨了这一发现的意义,据报道,在某些精神分裂症群体中MAO活性也发生了改变。在本研究中,发现低血小板GPx和高脑萎缩与非偏执型精神分裂症的DSM-III诊断、高度慢性化以及阴性症状占主导有关。与一些文献报道相反,脑萎缩在精神分裂症患者中也与年龄和病程相关,尽管这些因素的影响小于低GPx,而低GPx本身并不依赖于年龄。在情感障碍患者对照组中,脑室脑比率(VBR)与脑萎缩高度相关,但在精神分裂症组中并非如此,在精神分裂症组中,高VBR主要出现在DSM-III未分化亚组中。低GPx/高萎缩的精神分裂症患者血小板MAO水平正常,仅在偏执亚组中MAO显著降低,这与已报道的观察结果一致。没有证据表明抗精神病药物对这两种酶有诱导作用。