Objective It is to observe the changes of platelet 5-HT2A receptor binding force and the effect of lithium salt in bipolar and schizoaffective psychosis.Methods 23 patients with bipolar affective psychosis and 23 patients with schizoaffec-tive psychosis were selected to observation group, 46 cases of schizophrenia patients were selected to control group.The plate-let 5-HT2A receptor binding force was measured by isotope ligand binding assay in two groups.The degree of depression and anxiety were assessed with Hamilton Depression Scale ( HAMD) and Hamilton Anxiety Scale ( HAMA) , to identify patients with suicidal behavior and Dutch act, and judge the bipolar manic type, bipolar type, split type and split type manic depres-sion.Then the effect on treatment with lithium was observed.Results The platelet 5-HT2A receptor binding force in the ob-servation group were significantly higher than that in the control group (P<0.05).The platelet 5-HT2A receptor binding force of patients with suicidal behavior and Dutch act, dual phase depression and schizophrenia depression were markedly stronger than patients without suicidal behavior and Dutch act, bipolar manic and split manic respectively in observation group ( all P<0.05) .The effect of lithium treatment in effect is patients with suicidal behavior and Dutch act, and depression were significantly lower than that in patients with not suicidal behavior and Dutch act, and depression ( all P<0.05) .Conclusion The platelet 5-HT2A receptor binding capacity in patients with bipolar affective and schizoaffective psychosis are stronger than normal patients, and in patients with suicidal behavior and Dutch act are stronger than that with non suicidal behavior and Dutch act.The effect of lithium treatment in patients of higher platelet 5-HT2A receptor binding capacity is decreased than that of lower platelet 5-HT2A receptor binding force.%目的：研究双相情感性和分裂情感性精神病患者血小板5－HT2 A受体结合力的变化及锂盐治疗的效果。方法选取双相情感性精神病患者23例和分裂情感性精神病患者23例作为观察组，另选取住院精神分裂症患者46例作为对照组。用同位素配基结合技术测定2组血小板5－HT2A受体结合力，用汉密顿抑郁量表（HAMD）和汉密顿焦虑量表（HA-MA）分别评定患者的抑郁程度和焦虑程度，区分患者是否有自杀倾向和自杀行为，并判断双相躁狂型、双相抑郁型、分裂躁狂型和分裂抑郁型。观察患者采用锂盐治疗的效果。结果观察组血小板5－HT2A受体结合力明显比对照组强（P＜0．05）；有自杀倾向和自杀行为的患者、双相抑郁型和分裂抑郁型患者的血小板5－HT2A受体结合力比无自杀倾向和自杀行为的患者、双相躁狂型和分裂躁狂型患者强（P均＜0．05）；观察组有自杀倾向和自杀行为型及抑郁型患者锂盐治疗效果均显著低于没有无自杀倾向和自杀行为及抑郁型患者（P均＜0．05）。结论双相情感性和分裂情感性精神病患者的血小板5－HT2 A受体结合力要比正常者强，而有自杀倾向和自杀行为的患者血小板5－HT2 A受体结合力又要比无自杀倾向和自杀行为的患者强，而且血小板5－HT2A受体结合力强的患者锂盐治疗效果不及血小板5－HT2A受体结合力弱的患者。
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