Nielsen B M, Mehlsen J, Behnke K
Department of Psychiatry, Frederiksberg Hospital, Denmark.
Clin Physiol. 1988 Apr;8(2):193-9. doi: 10.1111/j.1475-097x.1988.tb00208.x.
The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven healthy subjects (32 +/- 7 years) served as controls. Immediate heart-rate responses to a single deep inspiration was used as a measure of parasympathetic function. Heart-rate response to standing was used as a measure of sympathetic function. Supine blood pressure, heart-rate and orthostatic changes in blood pressure did not differ between groups. Heart-rate response to standing was greater in both medicated and non-medicated schizophrenics compared to normal subjects (P less than 0.01). Heart-rate response to standing was greater in non-medicated compared to medicated schizophrenics (P less than 0.05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics seems to partly normalize the autonomic reactivity rather than being the cause of autonomic dysfunction.
本研究的目的是评估精神分裂症患者的自主神经功能。纳入了28名被诊断为精神分裂症且病情稳定正在服药的患者（年龄29±6岁），以及10名未服药的精神分裂症患者（年龄25±5岁）。11名健康受试者（年龄32±7岁）作为对照。对单次深吸气的即时心率反应被用作副交感神经功能的指标。对站立的心率反应被用作交感神经功能的指标。仰卧位血压、心率以及血压的直立位变化在各组之间没有差异。与正常受试者相比，服药和未服药的精神分裂症患者对站立的心率反应均更大（P<0.01）。与服药的精神分裂症患者相比，未服药的患者对站立的心率反应更大（P<0.05）。与正常受试者相比，未服药的精神分裂症患者对吸气的心率反应更大（P<0.05），而服药和未服药的精神分裂症患者之间未发现差异。结果表明，精神分裂症患者自主神经系统的平衡发生改变，交感神经和副交感神经分支均存在过度兴奋。因此，我们的研究表明自主神经系统本身存在功能障碍，对精神分裂症中注意力定向反应的先前解释受到质疑。使用抗精神病药物似乎部分使自主反应正常化，而不是自主功能障碍的原因。
