Roy A, Pickar D, De Jong J, Karoum F, Linnoila M
Clinical Studies Section, National Institute of Mental Health, Bethesda, MD 20892.
Arch Gen Psychiatry. 1988 Sep;45(9):849-57. doi: 10.1001/archpsyc.1988.01800330081010.
Among 140 depressed and control subjects, there were significant positive correlations between indexes of noradrenergic activity in cerebrospinal fluid (CSF), plasma, and urine. Among the depressed patients, CSF levels of the norepinephrine (NE) metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) and urinary outputs of NE and its metabolites normetanephrine, MHPG, and vanillylmandelic acid correlated significantly with plasma cortisol levels in relation to dexamethasone administration. Also, CSF levels of MHPG were significantly higher among patients who were cortisol nonsuppressors than among either patients who were cortisol suppressors or controls. Urinary outputs of NE and normetanephrine were significantly higher among patients who were cortisol nonsuppressors than among controls. Patients who were cortisol suppressors had indexes of NE metabolism similar to those of controls. These results in the depressed patients extend recent observations suggesting that dysregulation of the noradrenergic system and hypothalamic-pituitary-adrenal axis occur together in a subgroup of depressed patients.
在140名抑郁症患者和对照受试者中，脑脊液（CSF）、血浆和尿液中去甲肾上腺素能活性指标之间存在显著正相关。在抑郁症患者中，去甲肾上腺素（NE）代谢产物3-甲氧基-4-羟基苯乙二醇（MHPG）的脑脊液水平以及NE及其代谢产物去甲变肾上腺素、MHPG和香草扁桃酸的尿排出量与地塞米松给药后的血浆皮质醇水平显著相关。此外，皮质醇无反应者患者的脑脊液MHPG水平显著高于皮质醇反应者患者或对照者。皮质醇无反应者患者的NE和去甲变肾上腺素尿排出量显著高于对照者。皮质醇反应者患者的NE代谢指标与对照者相似。抑郁症患者的这些结果扩展了最近的观察结果，表明去甲肾上腺素能系统和下丘脑-垂体-肾上腺轴的失调在一部分抑郁症患者中共同出现。
