强迫症初发患者纹状体区磁共振质子波谱治疗前后的变化

Changes of proton magnetic resonance spectroscopy in patients with first episode obsessive-compulsive disorder with citalopram treatment

目的:探讨首发强迫症患者接受西酞普兰治疗前后纹状体区可能存在的代谢变化。方法:利用氢质子磁共振波谱分析技术1H-MRS检测20例首发强迫症患者治疗前后和20名健康志愿者纹状体区的多个代谢指标,包括N-乙酰天冬氨酸(NAA)、胆碱复合物(Cho)、肌酸(Cr)及肌醇(MI),并分别计算NAA、Cho、MI与Cr的比值。结果:首发强迫症患者治疗前双侧纹状体区NAA/Cr、Cho/Cr均较健康对照组明显升高(P<0.05),而MI/Cr与对照组比较无显著变化(P>0.05);接受治疗后NAA/Cr较治疗前明显降低(P<0.05),Cho/Cr和MI/Cr较治疗前的差异均无统计学意义(P>0.05)。结论:通过1H-MRS测量纹状体区代谢物的含量变化,可为临床评判强迫症患者的疗效提供一定的客观依据。

Objective： To explore the abnormality of the brain＇s metabolism about the bilateral corpus striatum in first-episode obsessive-compulsive disorder patients receiving citalopram. Methods： Using mag- netic resonance spectroscopy and analyzing technology1 H-MRS to detect multiple metabolic indices of the corpus striatum of 20 patients receiving eitalopram and 20 healthy persons, including NAA, Choline（Cho） , myoinositol（MI）, creatine（Cr）. Results： The value NAA/Cr and Cho/Cr in the eopus striatum of the first-episode of obsessive-compulsive disorder group were significantly higher than those in the control group before treatment（P 〈 0.05 ） ,the value of MI/Cr was no significant change compared with that in the control group （P 〉 0.05） ; after treatment, the value of NAA/Cr was lower than before treatment （ P 〈 0.05 ）, the value of Cho/Cr and MI/Cr were no significant change （P 〉 0.05）. Conclusion： 1 H-MRS can provide some objective basis for clinical evaluation of the efficacy of OCD patients by measuring the changes of the metabolites in the striatum.