Sodium lactate and hypertonic sodium chloride induce equivalent panic incidence, panic symptoms, and hypernatremia in panic disorder
Sodium lactate and hypertonic sodium chloride induce equivalent panic incidence, panic symptoms, and hypernatremia in panic disorder
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DOI：
10.1016/s0006-3223(98)00053-5
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发表时间：
1998-11-15
影响因子：
10.6
通讯作者：
Raskind, MA
中科院分区：
文献类型：
--
作者：
Peskind, ER;Jensen, CF;Raskind, MA
背景资料：虽然在30年前就有文献报道了通过输注0.5 mol/L乳酸钠对惊恐障碍患者进行惊恐诱导的实验，但这一观察结果的机制仍不清楚。在此，我们询问快速输注0.5 mol/L乳酸钠中所含的大量钠负荷是否可能参与惊恐诱导。研究方法：我们比较了惊恐障碍和健康受试者的行为，电解质，内分泌和酸碱反应的三个双盲随机顺序等体积20分钟输注：0.5 mol/L乳酸钠，高渗盐水（3%氯化钠），和生理盐水安慰剂。结果如下：在惊恐障碍受试者中，乳酸钠（0.5 mol/L）和高渗盐水产生了相同的惊恐发生率和惊恐症状、血清钠和血浆加压素的同等增加。无论是高渗输液增加皮质醇或肾上腺皮质激素。正常受试者在任何情况下都会经历恐慌。0.5-mol/L乳酸钠输注诱导酸中毒，而高渗盐水和生理盐水诱导轻度酸中毒。结论：含有氯离子或乳酸根离子的高渗钠溶液可引起惊恐障碍患者的惊恐。高渗盐水和0.5mol/L乳酸钠所提供的大量钠负荷可能参与了惊恐诱导的机制。出版社：Society of Biological Psychiatry
Background: Although experimental induction of panic by infusion of 0.5 mol/L sodium lactate in persons with panic disorder was described three decades ago, the mechanism underlying this observation remains unclear Here we asked if the rapid administration of the large sodium load contained in the 0.5-mol/L sodium lactate infusion might be involved in panic induction. Methods: We compared in panic disorder and healthy subjects behavioral, electrolyte, endocrine, and acid-base responses to three double-blind randomly ordered equal volume 20-min infusions: 0.5 mol/L sodium lactate, hypertonic saline (3% sodium chloride), and normal saline placebo. Results: Sodium lactate (0.5 mol/L) and hypertonic saline produced the same high incidence of panic and equivalent increases in panic symptoms, serum sodium, and plasma vasopressin in the panic disorder subjects. Neither hyper tonic infusion increased cortisol or adrenacorticotropin. Na normal subject experienced panic in any condition. The 0.5-mol/L sodium lactate infusion induced alkalosis, whereas hypertonic saline and normal saline induced a mild acidosis. Conclusions: Hypertonic sodium solution containing either chloride or lactate anion induces panic in panic disorder. The large sodium loads delivered by hypertonic saline and 0.5 mol/L sodium lactate may be involved in the mechanism of panic induction. Published by Society of Biological Psychiatry.