Hullin R P, Jerram T C, Lee M R, Levell M J, Tyrer S P
Br J Psychiatry. 1977 Dec;131:575-81. doi: 10.1192/bjp.131.6.575.
The paper describes a two-month period of study in four bipolar manic-depressive patients in a metabolic ward. Plasma renin activity, packed cell volume, plasma sodium and potassium were determined at intervals. Twenty-four-hour urinary sodium, potassium and creatinine were also estimated daily. Aldosterone production rate was measured on two occasions for each patient. Three of the patients showed at least one episode each of mania and depression during the study, while the fourth patient, who was receiving prophylactic lithium throughout, had one ten-day depressive episode but was otherwise normal. No obvious relationship between mood and plasma renin activity was observed, but the group showed a high resting renin activity, a blunted renin response to posture, and inappropriate aldosterone production rates for the renin activity found. It is postulated that a primary defect in the aldosterone-renin system may be present in bipolar manic-depressive psychosis.
该论文描述了在代谢病房对4例双相躁狂抑郁症患者进行的为期两个月的研究。定期测定血浆肾素活性、红细胞压积、血浆钠和钾。每天还估算24小时尿钠、钾和肌酐。对每位患者进行了两次醛固酮生成率测定。在研究期间，3例患者至少各出现一次躁狂和抑郁发作，而第4例患者一直在接受预防性锂治疗，有一次为期10天的抑郁发作，但其他方面正常。未观察到情绪与血浆肾素活性之间有明显关系，但该组患者静息肾素活性较高，肾素对体位的反应迟钝，且醛固酮生成率与所发现的肾素活性不相称。据推测，双相躁狂抑郁症精神病患者可能存在醛固酮 - 肾素系统的原发性缺陷。
