Cowley D S, Arana G W
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195.
Arch Gen Psychiatry. 1990 Mar;47(3):277-84. doi: 10.1001/archpsyc.1990.01810150077012.
Lactate infusion is the most extensively studied of the pharmacological challenge tests in panic disorder. We assessed the value of this test in the diagnosis and subtyping of panic in clinical and research settings. Analysis of lactate infusion studies to date suggests that patients with panic attacks are significantly more sensitive to lactate than are healthy controls or patients with other psychiatric disorders without panic attacks. However, the usefulness of lactate infusion is limited by the lack of standardized, objective criteria for lactate-induced panic and uncertainty as to the sensitivity and specificity of the test for current, clinically significant panic attacks. Except in rare cases, the clinical history is likely to be of more value than lactate response in diagnosing panic disorder. Determination of the role of the test in subtyping patients with panic disorder awaits further study of the diagnostic, prognostic, genetic, and pathophysiologic significance of lactate sensitivity.
乳酸输注是惊恐障碍中研究最广泛的药理学激发试验。我们评估了该试验在临床和研究环境中对惊恐的诊断及亚型分类的价值。对迄今为止乳酸输注研究的分析表明，惊恐发作患者对乳酸的敏感性显著高于健康对照者或无惊恐发作的其他精神障碍患者。然而，乳酸输注的效用受到乳酸诱发惊恐缺乏标准化、客观标准以及该试验对当前具有临床意义的惊恐发作的敏感性和特异性存在不确定性的限制。除了极少数情况外，在诊断惊恐障碍时，临床病史可能比乳酸反应更有价值。确定该试验在惊恐障碍患者亚型分类中的作用有待进一步研究乳酸敏感性的诊断、预后、遗传和病理生理意义。
