心律失常射频消融术后焦虑状态患者的前额叶背外侧皮层MRS初步研究

Preliminary study of MRS in dorsolateral prefrontal cortex of patients with anxiety after radiofrequency catheter ablation

目的心律失常射频消融术后患者出现焦虑状态,目前对于其发病原因缺乏全面了解,本研究通过MRS技术观察前额叶背外侧皮层区域代谢物的改变。方法本研究搜集符合纳入标准的32例心律失常射频消融术后焦虑状态患者作为RFCA组,同期纳入年龄、性别相匹配的32名健康志愿者作为对照组。结果左侧前额叶背外侧皮层,RFCA组(0.71±0.16)与对照组(0.87±0.14)相比,Cho/Cr比值减低有统计学差异(P=0.022,z=2.364);在右侧前额叶背外侧皮层,RFCA组(0.73±0.12)与对照组(0.84±0.15)相比,Cho/Cr比值减低有统计学差异(P=0.019,z=2.304)。其余代谢物比值均无统计学差异(P>0.05)。结论心律失常射频消融术后焦虑状态患者双侧前额叶背外侧皮层Cho水平的下降,可能反映病理性焦虑状态神经元的损伤及潜在的认知功能障碍,从而为该疾病的发病机制提供更多的证据。

Objective Patients with arrhythmia after radiofrequency catheter ablation exist anxious state. At present, the pathogenesis is unclear. MRS technique is used to observe the change of metabolites in the dorsolateral prefrontal cortex. Meth- ods In this study, 32 patients with anxiety disorder after radiofrequency catheter ablation were included as RFCA group. Age and sex matched thirty-two healthy volunteers were included as control group. Results In the left prefrontal cortex, the ratio of Cho/Cr was significantly lower in the RFCA group （0.71 ± 0. 16） than in the control group （ 0.87± 0.14） （ P = 0. 022, z = 2. 364）. The ratio of Cho/Cr was significantly lower in RFCA group （0.73 ±0.12） than that in control group （0.84 ±0.15） （ P = 0. 019, z = 2. 304） in the right prefrontal cortex. The ratio of other metabolites was not statistically significant （ P 〉 0.05 ）. Conclusion Patients present with anxiety after radiofrequeney ablation; the decrease in Cho levels in the dorsal lateral cortex of the prefrontal cortex may reflect the neuronal damage and potential cognitive dysfunction in pathological anxious condition, so as to provide more evidence for the pathogenesis of the disease.