抑郁症与急性创伤后应激障碍局部脑血流灌注研究

Study on regional cerebral blood flow perfusion in depressive disorder or acute posttraumatic stress disorder patients

目的:探讨抑郁症与急性创伤后应激障碍(post-traumatic stress disorder,PTSD)局部脑血流灌注(regional cerebral blood flow,r CBF)变化的异同。方法 :采用非侵入性脉冲式动脉自旋标记(pulsed arterial spin-labelling,PASL)技术与SPM5软件、PVE-lab软件研究抑郁症患者与急性PTSD患者的r CBF变化。研究对象包括30名抑郁症患者、30名急性PTSD患者和30名健康对照者。结果:与健康对照组相比,抑郁症患者及急性PTSD患者r CBF均明显降低。抑郁症患者与急性PTSD患者相比,右侧额上回眶面、额内侧回眶面、楔叶、距状回、楔前叶、辅助运动区、扣带回中部及左侧额中回眶面、额下回眶面、角回、中央前回r CBF明显降低。结论:抑郁症患者和急性PTSD患者r CBF变化均呈降低趋势,但抑郁症患者比急性PTSD患者r CBF降低更为明显。r CBF可以为这2种疾病的诊断和鉴别诊断提供客观依据。

Objective To compare depressive disorder and acute posttraumatic stress disorder（PTSD） for regional cerebral blood flow（rCBF）. Methods Pulsed arterial spin-labelling（PASL） technique, SPM5 software and PVE-lab software were used to explore the rCBF changes of 30 healthy volunteers, 30 depressive disorder patients and 30 PTSD patients. Results Compared with the health ones, the depressive disorder patients and PTSD patients had the rCBFs decreased significantly. Compared with the PTSD patients, the depressive disorder patients had the rCBFs obviously lowered in the right orbital of superior frontal gyrus, orbital of medial frontal gyrus, cuneus, calcarine gyrus, precuneus, supplementary motor area, middle of cingulum and the left orbital of middle frontal gyrus, orbital of inferior frontal gyrus, angular gyrus and precentral gyrus. Conclusion The rCBFs of both the depressive disorder patient and PTSD patient tend to decrease, while the former has more changes than the latter. It＇s suggested that rCBF be used for the diagnosis and differential diagnosis of depressive disorder and PTSD.