【摘要】 目的探讨抑郁症患者经过抗抑郁治疗后各项脑动脉血流速度的水平变化,分析其与认知功能的关系。方法回顾性分析2018年12月至2020年12月于太仓市第三人民医院治疗的76例抑郁症患者的临床资料,将其作为抑郁组,给予抗抑郁剂盐酸帕罗西汀片治疗,治疗6周;另回顾性分析68例同期进行健康体检的健康者的体检资料,将其作为健康对照组。经颅多普勒超声检测两组研究对象各项脑动脉血流速度;比较抑郁组患者治疗前后与健康对照组研究对象大脑动脉平均血流速度、数字划销测验(CT)、威斯康星卡片分类测验(WCST)成绩;治疗后抑郁组患者大脑动脉平均血流速度与CT成绩总净分、错误应答数的相关性。结果与治疗前比,治疗后抑郁组患者基底动脉平均血流速度显著升高;与健康对照组比,抑郁组患者治疗前与治疗后基底动脉、左大脑中动脉、右大脑中动脉、左大脑前动脉、右大脑前动脉平均血流速度均显著降低;与治疗前比,治疗后抑郁组患者净分Ⅰ、净分Ⅱ、净分Ⅲ、净分Ⅳ、净分Ⅴ、总净分等各项CT成绩均显著升高,但治疗后抑郁组患者的各项CT成绩仍显著低于健康对照组;与治疗前比,治疗后抑郁组患者错误应答数、持续性错误数水平均显著低于治疗前,治疗后其各项WCST成绩仍显著低于健康对照组(均P<0.05);CT成绩总净分与基底动脉、左大脑中动脉、右大脑中动脉、左大脑前动脉、右大脑前动脉血流速度均呈正相关(r=0.281、0.431、0.382、0.634、0.283,均P<0.05),错误应答数与基底动脉、左大脑中动脉、右大脑中动脉、左大脑前动脉、右大脑前动脉血流速度均呈正相关(r=0.352、0.521、0.328、0.312、0.302,均P <0.05)。结论经抗抑郁药物短期治疗后,抑郁症患者的注意力、执行功能、认知功能与动脉脑血流速度情况均可得到一定缓解,但与健康者相比仍显示异常,脑动脉血流速度改善与注意力、执行功能及认知功能恢复存在正相关关系,临床上可通过抑郁症患者认知功能损伤程度来判定其病情严重程度,并可采取相关功能训练与治疗来改善患者的认知功能,缓解病情。更多还原

【Abstract】 Objective To explore the relationship between cerebral arterial blood flow velocity and cognitive function in patients with depression after antidepressant therapy. Methods A retrospective analysis of the clinical datas of 76 patients with depression treated in The Third People’s Hospital of Taicang from December 2018 to December 2020, acted as the depression group, and treated with the antidepressant Paroxetine Hydrochloride tablets for 6 weeks. In addition, the physical examination datas of 68 cases healthy subjects who underwent physical examination at the same period were retrospectively analyzed and acted as the healthy control group. Transcranial Doppler ultrasound was used to detect the blood flow velocity of various cerebral arteries of subjects in the two groups. Compared the average cerebral arterial blood flow velocity, the digital cancellation test(CT), and the Wisconsin Card Sorting Test(WCST) score of patients in the depression group before and after treatment and the subjects in the healthy control group; analysed the correlation between the average cerebral arterial blood flow velocity and the total net score of CT score and the total number of WCST error responses of patients in the depression group after treatment.Results Compared with before treatment, the mean blood flow velocity of basilar artery of patients in the depression group increased significantly after treatment; compared with the healthy control group, the mean blood flow velocity of basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery and right anterior cerebral artery of patients in the depression group reduced significantly after treatment; compared with before treatment, the net score Ⅰ, net score Ⅱ, net score Ⅲ, net score Ⅳ, net score Ⅴ, total net score of each item in CT score of patients in the depression group increased significantly after treatment, but all items after treatment CT score were still significantly lower than the healthy control group; compared with before treatment, the number of error responses and the number of persistent errors of patients in the depression group after treatment were significantly lower than before treatment, and the WCST score were still significantly lower than those of the healthy control group after treatment(all P<0.05); the total net score of CT score was positively correlated with the blood flow velocity of the basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery,and right anterior cerebral artery(r = 0.281, 0.431, 0.382, 0.634, 0.283, all P<0.05); the number of error responses was positively correlated with the blood flow velocity of the basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery, and right anterior cerebral artery(r = 0.352, 0.521, 0.328, 0.312, 0.302, all P<0.05). Conclusion After short-term treatment with antidepressants, the attention, executive function, cognitive function and arterial cerebral blood flow rate of depression patients can be relieved to a certain extent,but it still shows abnormality compared with healthy people, there is a positive correlation between the improvement of cerebral arterial blood flow speed and the recovery of attention, executive function and cognitive function, clinically, the severity of depression can be judged by the degree of cognitive impairment in patients with depression, relevant functional training and treatment can be taken to improve the cognitive function of the patient and relieve the condition.更多还原