Ambade V, Arora M M, Singh P, Somani B L, Basannar D
Scientist E, Scientist E (Dept of Community Medicine) , AFMC, Pune-40.
Head of Department, Scientist E (Dept of Community Medicine) , AFMC, Pune-40.
Med J Armed Forces India. 2009 Jul;65(3):216-20. doi: 10.1016/S0377-1237(09)80006-3. Epub 2011 Jul 21.
Abnormalities of catecholaminergic function have been hypothesised in causation of depressive illness. Electroconvulsive therapy (ECT) is postulated to have noradrenergic mechanism of action. We studied the clinical utility of estimating catecholamines level changes after ECT.
Plasma adrenaline, noradrenaline and dopamine in healthy controls and depressed patients were estimated by high performance liquid chromatography with electrochemical detection method before and after ECT.
Mean ± standard deviation of plasma adrenaline, noradrenaline and dopamine in controls was 36.7 ± 13.2, 209.3 ± 76, 21.8 ± 9.5 ng/L respectively, while in depressed patients before and after ECT it was found to be 32.5 ± 12.0, 419.3 ± 167.7, 22.1 ± 16.0ng/ L and 37.2 ± 19.6, 386.1 ± 168.4, 22.3 ± 15.5ng/L respectively. Correlation of adrenaline, noradrenaline and dopamine concentration with scores of Beck Depression Inventory, Suicidal Ideation Scale and Melancholia Inventory was positive but statistically not significant and poor. Based on the cut off values of noradrenaline, only 62% cases could be categorized as abnormal, which after ECT reduced to 50%, whereas post ECT psychiatric ratings was normal in about 78% cases.
There is no clinical significance of estimating adrenaline, noradrenaline and dopamine in depressed patients.
儿茶酚胺能功能异常被认为与抑郁症的病因有关。电休克疗法（ECT）被假定具有去甲肾上腺素能作用机制。我们研究了评估ECT后儿茶酚胺水平变化的临床实用性。
采用高效液相色谱电化学检测法，对健康对照者和抑郁症患者在ECT治疗前后的血浆肾上腺素、去甲肾上腺素和多巴胺进行测定。
对照组血浆肾上腺素、去甲肾上腺素和多巴胺的均值±标准差分别为36.7±13.2、209.3±76、21.8±9.5 ng/L，而抑郁症患者ECT治疗前和治疗后的相应值分别为32.5±12.0、419.3±167.7、22.1±16.0 ng/L和37.2±19.6、386.1±168.4、22.3±15.5 ng/L。肾上腺素、去甲肾上腺素和多巴胺浓度与贝克抑郁量表、自杀观念量表和忧郁症量表评分呈正相关，但在统计学上无显著意义且相关性较差。根据去甲肾上腺素的临界值，仅62%的病例可被归类为异常，ECT治疗后这一比例降至50%，而ECT治疗后约78%的病例精神评定正常。
评估抑郁症患者的肾上腺素、去甲肾上腺素和多巴胺水平无临床意义。
