Nesse R M, Cameron O G, Curtis G C, McCann D S, Huber-Smith M J
Arch Gen Psychiatry. 1984 Aug;41(8):771-6. doi: 10.1001/archpsyc.1984.01790190045005.
Increased beta-adrenergic receptor sensitivity could account for many aspects of panic disorder. We tested this hypothesis by comparing 14 patients with six normal control subjects. The controls and eight patients had 14 blood samples taken, and heart rate and BP measured, during a four-hour protocol that included supine rest, a posture and isometric exercise stimulus, and a series of up to seven logarithmically increasing bolus intravenous doses of isoproterenol hydrochloride. The other six patients were studied only at rest. Patients had markedly elevated resting heart rate, substantially elevated levels of plasma epinephrine, cortisol, and growth hormone, mildly elevated plasma norepinephrine levels, and decreased heart rate responses to isoproterenol. These results suggest that beta-adrenergic receptor response is not increased, and may be decreased, in patients with panic disorder. Receptor down-regulation could result from the increased adrenergic function that these patients demonstrate, even in the absence of panic attacks.
β-肾上腺素能受体敏感性增加可能是惊恐障碍诸多方面的原因。我们通过将14名患者与6名正常对照者进行比较来验证这一假设。在一个长达4小时的方案中，对照组和8名患者采集了14份血样，并测量了心率和血压，该方案包括仰卧休息、体位和等长运动刺激，以及一系列多达7次按对数递增的盐酸异丙肾上腺素静脉推注剂量。另外6名患者仅在休息时接受研究。患者静息心率显著升高，血浆肾上腺素、皮质醇和生长激素水平大幅升高，血浆去甲肾上腺素水平轻度升高，对异丙肾上腺素的心率反应降低。这些结果表明，惊恐障碍患者的β-肾上腺素能受体反应并未增加，甚至可能降低。即使在没有惊恐发作的情况下，这些患者所表现出的肾上腺素能功能增强也可能导致受体下调。
