阴性和阳性症状为主型精神分裂症患者脑部质子波谱与症状相关性

Brain Protons Spectrum and Symptoms of Schizophrenia Patients with Mainly Negative and Positive Symptoms

目的探讨阴性和阳性症状为主型的精神分裂症患者脑部磁共振质子波谱(1H-MRS)与临床症状之间的相关性。方法对住院诊治的89例精神分裂症患者采用阳性与阴性症状量表(PANSS)评定症状,用1H-MRS测定患者前额叶及丘脑生化代谢物N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr),计算NAA/Cr值。结果阴性组阴性症状(29.03±7.13)分、阳性症状(20.43±4.46)分、一般病理(40.21±5.43)分、总分(90.24±8.87)分;阳性组阴性症状(20.12±3.64)分、阳性症状(30.31±3.55)分、一般病理(40.76±5.54)分、总分(89.98±9.23)分,两组患者阴性症状及阳性症状分值之间比较存在显著性差异(P<0.05);NAA/Cr值阴性组前额叶左侧(1.34±0.35)、右侧(1.38±0.37),丘脑左侧(1.45±0.36)、右侧(1.46±0.37);阳性组前额叶左侧(1.37±0.36)、右侧(1.40±0.37),丘脑左侧(1.49±0.36)、右侧(1.64±0.39),丘脑右侧NAA/Cr值在两组间比较存在显著性差异(P<0.05);阴性组患者左侧前额叶NAA/Cr值与PANSS总分、阴性症状总分之间均具有负相关(r=-0.34,-0.36;P<0.05),阳性组患者左侧前额叶NAA/Cr值与PANSS总分之间具有负相关(r=-0.35,P<0.05)。结论精神分裂症阳性与阴性为主型的患者前额叶及丘脑均存在NAA/Cr值变化,前额叶NAA/Cr值与阴性症状的严重程度密切相关。

Objective To explore the correlation between brain proton magnetic resonance spectroscopy（1 H-MRS）and the clinical symptoms of schizophrenia patients with mainly positive and negative symptoms.Methods Using positive and negative symptom scale（PANSS） to evaluate symptoms of 89 patients with schizophrenia in our hospital Using 1 H-MRS to determinate prefrontal and thalamus patients with biochemical metabolites N-acetyl aspartic acid（NAA）,creatine complex（Cr）,the calculation of NAA/Cr value.Results Negative symptoms score of negative group was（29.03±7.13）,positive symptom was（20.43±4.46）,general pathology was（40.21±5.43） points,total score was（90.24±8.87）;Negative symptom score of positive group was（20.12±3.64）,positive symptom was（30.31±3.55） points,general pathology was（40.76±5.54）,total score was（89.98±9.23）,there were significant differences in negative symptoms and positive symptoms scores between two groups（P0.05）;NAA/Cr values of negative group were left prefrontal（1.34±0.35）,the right（1.38±0.37）,the thalamus left（1.45±0.36）,the right（1.46±0.37）,those of positive group were left prefrontal（1.37±0.36）,the right（1.40±0.37）,the thalamus left（1.49±0.36）,the right（1.64±0.39）,there existed significant difference in the thalamus right NAA/Cr value（P0.05）;In negative group of patients,the left prefrontal NAA/Cr value had negative correlation with the total score,total negative symptoms PANSS（r=-0.34,-0.36;P0.05）,in positive group of patients,the left prefrontal NAA/Cr value had negative correlation with total PANSS（r=-0.35,P0.05）.Conclusion Schizophrenia patients with mainly positive and negative symptoms have NAA/Cr value change in the prefrontal and thalamus,and prefrontal NAA/Cr value is closely related to the severity of negative symptoms.