精神分裂症患者前额叶和丘脑的质子磁共振波谱研究

A proton magnetic resonance spectroscopy imaging study on prefrontal lobe and thalamus in patients with schizophrenia

目的探讨精神分裂症患者前额叶、丘脑的氢质子磁共振波谱（^1H-MRS）的特点。方法以38例精神分裂症患者为研究对象（患者组），以38名正常人为对照组。两组对象在入组24h内采用多体素。H-MRS检测前额叶和丘脑N-乙酰基天门冬氨酸（NAA）、胆碱复合物（Cho）与肌酸复合物（Cr），完成NAA／Cr值、Cho／Cr值和NAA／（Cho＋cr）值的计算。采用t检验进行分析。结果组间比较，患者组左侧前额叶及左、右侧丘脑NAA／Cr值（分别为1．32±0．36，1．53±0．30，1．48±0．37）均低于对照组（分别为1．74±0．27，1．72±0．26，1．73±0．29），差异均有统计学意义（￡检验；P均〈0．05）；患者组左侧前额叶NAA／（Cho＋cr）值（0．64±0．13）低于对照组（0．74±0．22），差异有统计学意义（t=2．26，P〈0．05）。组内比较，患者组和对照组的前额叶及丘脑左、右两侧各生化物质代谢指标的差异均无统计学意义（t检验；P均〉0．05）。结论精神分裂症患者存在前额叶及丘脑神经元的功能和（或）结构异常，精神分裂症患者和正常人脑部NAA、Cho、Cr可能并不存在侧化现象。

Objective To identify the metabolite levels in prefrontal lobe and thalamus in patients with schizophrenia by proton magnetic resonance spectroscopy （^1H-MRS）. Methods Thirty-eighty schizophrenics and 38 normal controls were involved in this study. A multi-voxel ^1H-MRS was given to all the subjects on prefrontal lobe and thalamus within 24 hours they got in hospital. The N-acetylaspartate （NAA）, choline-congtaining compounds （Cho）, and creatine compounds （Cr） were measured and the ratios of NAA/Cr, Cho/Cr and NAA/（ Cho ＋ Cr） were determine＆ Results In left prefrontal lobe and bilateral thalamus, the NAA/Cr ratio in patients demonstrated lower than that in normal controls （ all P 〈 0.05）. In left prefrontal lobe, the NAA/（ Cho ＋ Cr） ratio in patients showed lower than that in normal controls （0.64 ±0. 13 vs. 0. 74 ±0. 22,t =2. 26, P 〈0. 05）. Both in patients and in normal controls, there were no significant differences in NAA/Cr, Cho/Cr and NAA/（ Cho ＋ Cr） between the two sides （all P 〉 0. 05）. Conclusions Abnormalities in neuronal function and/or integrity are present in schizophrenics. There is no significantly lateralized asymmetry for metabolite levels such as NAA, Cho and Cr in either the schizophrenics or the controls.