洪沪津+徐枝楼+叶鑫武

[摘要] 目的 探讨苯丙胺所致精神障碍患者的血清心肌酶谱的变化特点及其临床意义。 方法 检测24例苯丙胺所致精神障碍患者血清中心肌酶谱数值，并同25例精神分裂症患者相对照，并用简明精神病量表（BPRS）评定病情变化。 结果 苯丙胺所致精神障碍患者入院时心肌酶谱各项指标均显著高于精神分裂症组（P<0.01），且与患者的精神症状的严重程度呈正性相关，病情得到控制后，患者的心肌酶谱的各项指标都逐渐下降并转为正常。 结论 苯丙胺所致精神障碍患者的心肌酶的活性明显增高，且与患者的精神症状的严重程度相关，临床上检测苯丙胺所致精神障碍患者的心肌酶谱对其病情估计有一定的临床价值。

[关键词] 心肌酶；苯丙胺；精神障碍

[中图分类号] R749.6 [文献标识码] B [文章编号] 1673-9701（2014）31-0004-04

Clinical observation of myocardial enzymogram in patients with benzedrine-induced psychotic disorder

HONG Hujin1 XU Zhilou2 YE Xinwu1

1.Department of Psychiatry， the Seventh People's Hospital of Wenzhou City in Zhejiang Province，Wenzhou 325000，China； 2.Department of Psychiatry， Wenzhou Kangning Hospital in Zhejiang Province，Wenzhou 325000，China

[Abstract] Objective To explore clinical significance and characteristics of changes of myocardial enzyme spectrum in patients with benzedrine-induced psychotic disorder. Methods The serum myocardial enzyme spectrum of 24 patients with benzedrine-induced psychotic disorder were detected by automatic biochemistry analyzer， which were compared with cases in 25 schizophrenics. The Brief Psychiatric Rating Scale （BPRS） was used to evaluate the state of the illness changes. Results All indexes of myocardial enzyme spectrum were significantly higher in patients with benzedrine-induced psychotic disorder than in control group （P<0.01）， which was positively correlated with the the severity of psychotic symptoms. All indexes declined and returned to normal after the condition was under satisfaction control. Conclusion The activity of serum myocardial enzyme was significantly increased， which was closely related with the severity of psychotic symptoms. Measurement of myocardial enzyme spectrum has clinical value for assessing the condition caused by benzedrine-induced psychotic disorder.

[Key words] Myocardial enzyme；Benzedrine；Psychotic disorder

苯丙胺类兴奋剂（Amphetamine-type-stimulants，ATS）是近年来被国际上广泛采纳用来描述苯丙胺、3，4亚甲二氧基甲基苯丙胺（MDMA）、甲基苯丙胺（冰毒）、摇头丸等兴奋剂的术语[1]。受国际ATS泛滥的影响，近年来我国滥用苯丙胺类兴奋剂人员呈逐年增加趋势，导致精神障碍患者也随之增多。苯丙胺直接作用于中枢神经系统而产生强烈的兴奋或抑制作用，长期反复滥用可使学习、记忆、运动功能受损并产生依赖[2]。心肌酶属于胞浆酶，广泛存在于人体的肌肉、骨骼、肝脏、肺以及心肌细胞组织中[3]。当这些器官组织受到损伤时，器官组织的细胞膜的完整性受损，细胞内的物质和酶被释放到血液当中。临床实践中检测心肌酶谱的水平可反映心肌功能的状态，是病情监测和诊断有无早期心肌梗死的重要指标[3-5]。在临床实践工作中，我们通过检测心肌酶谱发现苯丙胺所致精神障碍患者很多，呈现异常增高现象，为了探讨血清心肌酶谱变化的临床意义以及是否与病情有关系，现对24例患者进行心肌酶谱的重点观察，并同25例精神分裂症患者进行对照分析，现报道如下。……