【摘要】 目的探讨抑郁症患者前额叶、海马的磁共振质子波谱(1H-MRS)变化特点。方法应用1H-MRS成像技术检测26例抑郁症患者(抑郁症组)和20名健康对照者(对照组)的前额叶、海马N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)3种代谢物,计算NAA/Cr和Cho/Cr比值。以抑郁症组年龄的中位数(38.5岁)为界将抑郁症组和对照组分为低年龄组[(28±7)岁,14例;(22±6)岁,9名]与高年龄组[(54±9)岁,12例;(53±7)岁,11名]。按病程分为首次发病组(19例,以下简称首发组)和复发组(7例)。采用方差分析进行统计比较。结果高年龄组患者左侧前额叶Cho/Cr(1.60±0.45)×10-6高于对照组(1.28±0.20)×10-6,差异有统计学意义(P<0.05);低年龄组患者右侧前额叶Cho/Cr(1.74±0.51)×10-6高于对照组(1.22±0.40)×10-6,差异有统计学意义(P<0.01)。高年龄组患者左侧海马NAA/Cr(1.16±0.31)×10-6低于对照组(2.21±0.83)×10-6,差异有统计学意义(P<0.01);低年龄组患者左侧海马Cho/Cr(1.54±0.44)×10-6高于对照组(1.08±0.35)×10-6,差异有统计学意义(P<0.05)。首发组患者左侧前额叶Cho/Cr(1.57±0.42)×10-6高于对照组(1.26±0.21)×10-6,复发组患者右侧前额叶Cho/Cr(1.77±0.50)×10-6高于对照组(1.29±0.32)×10-6,差异均有统计学意义(P均<0.01)。首发组患者左侧海马NAA/Cr(1.19±0.26)×10-6及复发组患者左侧海马NAA/Cr(1.10±0.29)×10-6均低于对照组(1.87±0.81)×10-6,复发组患者右侧海马Cho/Cr(2.13±0.51)×10-6高于对照组(1.51±0.52)×10-6,差异均有统计学意义(P均<0.01)。结论抑郁症患者可能存在前额叶、左侧海马细胞膜代谢异常,高年龄抑郁症患者的左侧海马神经元活力下降。更多还原

【Abstract】 Objective To identify the possible alterations of brain functioning in prefrontal lobe and hippocampus in patients with depression using proton magnetic resonance spectroscopy (1H-MRS).Methods 1H-MRS was performed on prefrontal lobe and hippocampus in 26 patients with depression and 20 control. The median age of patients was 38.5 years. The patients were divided into the elder group [ (54±9)years old,n=12] or the younger group [(28±7)years old, n=14]. The patients were also separated into two groups according the illness duration, i.e., the first-episode group (19 cases) and recurrent group (7 cases).The NAA, Cho and Cr were measured and the ratios of NAA/Cr and Cho/Cr were determined.Results The Cho/Cr ratios in left prefrontal lobe in elder patients and right prefrontal in younger patients were higher than that in normal controls (left: P<0.05,right: P<0.01), respectively. In left hippocampus, the NAA/Cr ratio in elder patients was lower than that in controls (P<0.01) while the Cho/Cr in younger patients higher than that in controls (P<0.05). The Cho/Cr ratios in left prefrontal lobe of first-episode patients and right prefrontal lobe of recurrent patients were higher than that in controls (first-episode: P<0.01; recurrent: P<0.01). The NAA/Cr ratios in left hippocampus of first-episode patients and recurrent patients were lower than that in controls (P<0.01). And the Cho/Cr ratio in right hippocampus of recurrent patients was higher than that in controls(P<0.01).Conclusion There might exist both abnormal turnover of membrane in prefrontal lobe and left hippocampus in patients with depression and reduced neuronal function in left hippocampus of the elder patients.更多还原