脑小血管病MRI特征与血管性抑郁的相关性

Relationship between MRI features of cerebral small vessel disease and vessel-related depression

目的探讨脑小血管病(CSVD)MRI特征与血管性抑郁的关系。方法选择CSVD患者93例:有抑郁症状50例(DS组),无抑郁症状43例(NDS组)。比较两组动脉硬化危险因素、脑白质病变(WMLs)评分和腔隙性脑梗死(LI)病灶计数,分析患者动脉硬化危险因素及MRI表现与抑郁的关系。结果DS组饮酒和高血脂发生率高于NDS组(58.0%vs.30.2%和42.0%vs.20.9%)(P<0.01);DS组WMLs评分和LI病灶总数多于NDS组(P<0.01)。额区、颞区和基底节区的LI病灶数量与9条目患者健康问卷(PHQ-9)分值呈正相关(P<0.01),而顶枕区和幕下区LI病灶数量与PHQ-9分值无相关性。结论 LI病灶的数量和部位均与CSVD的抑郁有关。额区、颞区和基底核区LI病灶数量与抑郁严重度呈正相关。

Objective To investigate the relationship between MRI features of cerebral small vessel disease（CSVD） and vessel-related depression. Methods A total of 93 patients with CSVD was assigned into two groups of DS （50 cases with depressive symptoms） and B （43 cases without depressive symptoms）. The risk factors for arteriosclerosis, scores of white matter lesions（WMLs） and the number of lacunar infartion（LI） were compared. The relationship between the risk factors for arteriosclerosis and MRI features and depressive symptoms was analyzed. Results The percentages of alcohol drinking anti hyperlipidemia were higher in group DS than those in group NDS（58. 0% vs. 30.2% and 4：2.0% vs. 20. 9%）（P〈0. 01）. Scores of WMLs and the total numbers of LI lesions were more in group DS than those in group NDS（P〈0. 01）. The numbers of LI lesions in frontal,temporal and basal ganglia regions, but not parieto-occipital and infratentorial areas, were positively correlated to PHQ-9 scores（P〈0. 01）. Conclusion The number and location, especially in the frontal, temporal and basal ganglia regions, of LI are related to CSVD-related depressive symptoms.