首发未治疗的精神分裂症患者不同脑区葡萄糖代谢水平

Glucose metabolism in various brain regions in first episode drug-naive patients with schizophrenia

目的通过观察首发未治疗的精神分裂症患者不同脑区葡萄糖代谢水平,探讨精神分裂症的病理生理学基础。方法纳入符合国际疾病分类标准第10版的首发未治疗的精神分裂症患者18例(观察组),同时选择和观察组年龄和性别相匹配的健康志愿者18人,分别进行正电子发射断层(PET/FDG,position emission tomography/18F-氟代脱氧葡萄糖)扫描,利用参数统计图(SPM)将两组进行配对t检验,分析两组间脑局部葡萄糖代谢差异。结果观察组左颞下回、左颞叶梭状回葡萄糖代谢水平升高,右侧顶下小叶、右侧顶叶缘上回、左顶下小叶、右侧中央后回、右侧额叶辅助运动区葡萄糖代谢水平明显低于健康志愿者,差异均有统计学意义(P<0.05)。结论首发未用药精神分裂症患者不同脑区葡萄糖代谢水平不同,其中颞叶代谢增高,顶叶、额叶代谢降低。

Objective To investigate the basic mechanisms of the pathophysiology of schizophrenia by observing local glucose metabolism in various brain regions in first- episode patients with schizophrenia. Methods Relative regional cerebral glucose metabolism was measured with fluorine- 18 deoxyglucose（ 18F- FDG） positron emission tomography（ PET） scan in 18 patients with first- episode untreated schizophrenia who met the diagnostic criteria in the 10 th edition of the international classification of diseases（ ICD- 10） and in 18 healthy individuals. PET data were analyzed using Statistical Parametric Mapping（ SPM） and paired t- tests. Regional cerebral glucose metabolism was compared between the two groups. Results Compared with the normal control group,patients with schizophrenia exhibited significant regional cerebral glucose metabolic abnormalities including increases of glucose metabolism in the left inferotemporal gyrus and left temporal fusiform gyrus,decreases of glucose metabolism in the right inferoparietal lobule,right supramarginal gyrus,left inferoparietal lobule,right postcentral gyrus and right supplementary motor area（ P〈0. 05）. Conclusion A reciprocal glucose metabolism pattern is revealed untreated patients with schizophrenia,with enhanced glucose metabolism in the temporal lobe and reduced glucose metabolism in the parietal lobe and the frontal lobe.