Gaffney F A, Fenton B J, Lane L D, Lake C R
Department of Medicine, University of Texas Health Science Center, Southwestern Medical School, Dallas 75235-9034.
Arch Gen Psychiatry. 1988 Jan;45(1):53-60. doi: 10.1001/archpsyc.1988.01800250063008.
Hemodynamic, ventilatory, and biochemical variables were measured in ten healthy adults and ten panic patients during infusion of 0.5 mol/L of sodium lactate. Physical activity, fitness level, and ambulatory electrocardiograms were also recorded. Lactate infusion doubled cardiac output, increased blood lactate levels by sixfold, and produced hypernatremia, hypocalcemia, and decreased serum bicarbonate levels in both groups but raised arterial pressure only in the patients. The patients hyperventilated before and during the infusion. Physiological responses and somatic complaints with the infusion differed little between the groups, but emotional complaints were six times more frequent among the panic patients. Eight patients but no control subjects interpreted their symptoms as a panic attack. Heart rate increased with only 14 of 31 recorded spontaneous outpatient panic attacks. Sodium lactate infusions appear to produce panic by mimicking the physiology of spontaneous panic. Treatment with cardioactive agents is not indicated in the absence of cardiopulmonary or autonomic nervous system abnormalities.
在10名健康成年人和10名惊恐症患者输注0.5摩尔/升乳酸钠期间，测量了血流动力学、通气和生化变量。还记录了身体活动、健康水平和动态心电图。乳酸输注使两组的心输出量加倍，血乳酸水平升高了六倍，并导致高钠血症、低钙血症和血清碳酸氢盐水平降低，但仅使患者的动脉压升高。患者在输注前和输注期间过度通气。两组之间输注时的生理反应和躯体不适差异不大，但惊恐症患者的情绪不适频率高出六倍。8名患者将其症状解释为惊恐发作，而对照组中无人如此。在记录的31次门诊自发性惊恐发作中，只有14次发作时心率增加。乳酸钠输注似乎通过模拟自发性惊恐的生理过程而引发惊恐。在没有心肺或自主神经系统异常的情况下，不建议使用心血管活性药物进行治疗。
