肠易激综合征患者情绪障碍调查及其发生机制研究

Mood in Irritable Bowel Syndrome Patients and Correlation with SPECT Cerebral Blood Flow Perfusion

目的研究肠易激综合征(IBS)患者抑郁、焦虑发生情况及其发生的病理生理机制。方法对50例IBS患者和50例正常对照者进行抑郁自评(SDS)、焦虑自评(SAS)及艾森克个性问卷(EPQ);并将抑郁、焦虑评分与局部脑血流灌注量进行相关分析。结果 IBS患者抑郁发生率为76%,以中度抑郁为主;焦虑发生率为46%,以轻度焦虑为主;对照组无抑郁发生,轻度焦虑10.6%。抑郁评分与左侧屏状核,左侧豆状核、右侧直回、右侧钩回血流灌注呈负相关,与左侧楔叶、两侧楔前叶、左侧枕上回、右侧缘上回、右侧顶下小叶血流呈正相关。焦虑评分与左侧屏状核、左侧岛叶血流呈负相关。结论 IBS患者存在明显抑郁、焦虑情绪;大脑血流灌注异常可能是其发生情绪障碍的病理生理机制之一。

Objective The mood change and its related factors were analyzed in patients with Irritable bowel syndrome （IBS） to study its possible pathophysiological mechanism. Metheds Mood changes were assessed with Self - Rating Depression Scale （SDS） for depression and Self- Rating Anxiety Scale （SAS） for anxiety in 50 patients with hyperthyroidism and 50 healthy controls. EPQ questionair was used to get personality traits for both patients and controls. The correlations were done be- tween SDS, SAS scores and regional cerebral blood flow peffusion （rCBF） of person. ReSults 76 percent of the patients had depression and 46% had anxiety, and the difference was significant （P 〈 0. 05 ）. There were negative correlations between scores of depression and rCBF in left claunstrum, left lentiform, right rectus gyrus and right uncus; and negative correlation be- tween scores of depression and rCBF in left cuneus, bilateral precuneus, left superior occipital gyrus, right superior marginal gy- rus and right inferior parietal lobe. Regional cerebral blood flow in left lentiform and left insula were negatively correlated with of anxiety. Conclusion Depression and anxiety are found in patients with IBS. Abnormal cerebral blood flow peffusion might be one of the possible mechanisms in mood disorder.