首发抑郁症患者敏感脑结构的磁共振质子波谱分析

The study of magnetic resonance spectrum about sensitive brain structure of the first episode depression

目的探讨首发抑郁症患者海马、前额叶扣带回及丘脑的脑代谢有无异常。方法利用质子磁共振波谱分析技术^1H—MRS检测20例首发抑郁症患者和20名健康志愿者的海马、前额叶扣带回及丘脑的多个代谢指标，包括包括N-乙酰天门冬氨酸盐（NAA）、胆碱复合物（Cho）、肌醇（MI）、肌酸（Cr）。结果与对照组相比，抑郁症组患者双侧丘脑的MI／Cr值下降[左（0．23±0．13），（0．25±0．09），t=2．25，P=0．03；右（0．33±0．15．0．34±0．04），t=2．42，P=0．02]；抑郁症组患者双侧海马的NAA／Cr，Cho／Cr均低于对照组（NAA／Cr：左t=3．06，P=0．004，右t=3．54，P=0．001．Cho／Cr：左t=2．94，P=0．006，右t=4．02，P=0．001）；抑郁症组患者前额叶扣带回皮质的Cho／Cr、MI／Cr比值均明显高于对照组（NAA／Cr：t=3．12，P=0．003．Cho／Cr：t=2．62，P=0．01）。结论海马、前额叶扣带回及丘脑的代谢异常可能构成首发抑郁症的神经生物学基础。

Objective To explore the brain＇s metabolism about the hippocampus,anterior cingulate and thalamus of first episode depressive patients. Methods Using proton magnetic resonance spectroscopy and 1H- MRS analyzing technology to detect multiple metabolic indices of the hippocampus,anterior cingulate and thalamus of 20 patients and 20 healthy persons, including N-acetylaspartate （ NAA）, choline （ Cho ） , myoinositol （ MI ） , crea- tiMe（Cr）. Results The ratios of MI/Cr of the bilateral thalamus of the depressive patients group decreased （ Left （0.23 ±0.13） ,（0.25 ±0.09）, t=2.25, P=0.03,Right（0.33 ±0.15,0.34 ±0.04）, t=2.42, P=0. 02）. The ratios of NAA/Cr and Cho/Cr of the bilateral hippocampus of the depressive patients group were both lower （ NAA/Cr ： Left t = 3.06, P = 0. 004, Right t = 3.54, P = 0. 001. Cho/Cr ： Left t = 2.94, P = 0.006, Right t = 4.02, P=0. 001 ）. The ratios of Cho/Cr and MI/Cr of the anterior cingulate of the depressive patients group were both significantly higher （ NAA/Cr： t = 3. 12, P = 0. 003 ; Cho/Cr： t = 2.62, P = 0.01 ）. Conclusion The metabolic abnormalities of hippocampus, anterior cingulate and thalamus maybe constitute the nervous biochemical basis of first episode depression.