首发精神分裂症偏执型患者的MRS研究

MRS study of first-episode patients with positive symptoms of schizophrenia

目的:利用磁共振质子波谱成像(~1H-MRS)探讨首发偏执型精神分裂症(SP)患者双侧额叶、海马头部、扣带前回代谢物质的特点。方法:利用1H-MRS检测22例首发偏执型SP患者(患者组)和22例健康志愿者(对照组)双侧额叶白质、海马头部及扣带前回的NAA、Cho及Cr值,得出NAA/Cr及Cho/Cr比值,后行组内及组间配对t检验。结果:(1)患者组组内比较:左侧额叶白质NAA/Cr低于右侧(P<0.05),左侧海马头部Cho/Cr、NAA/Cr低于右侧(均P<0.05);双侧额叶白质Cho/Cr及双侧扣带前回NAA/Cr、Cho/Cr差异均无统计学意义(均P> 0.05)。(2)组间比较:患者组左侧额叶白质及左侧海马头部NAA/Cr均低于对照组(均P<0.05);右侧额叶白质、右侧海马头部及双侧扣带前回NAA/Cr与对照组差异均无统计学意义(均P> 0.05)。双侧额叶白质、双侧海马头部及扣带前回的Cho/Cr与对照组差异均无统计学意义(均P> 0.05)。结论:首发偏执型SP患者左侧额叶白质、海马头部神经元数量和(或)功能普遍降低,提示SP患者早期存在脑生物学功能异常,支持SP病因学偏侧化特征假说。

Objective：To explore the biological chemical metabolic features in the frontal white matter,the head of hippocam- pus and the anterior eingulated faseiculus in first-episode patients with positive symptoms of schizophrenia by ^1H-MRS. Methods： Twenty-two first-episode patients with paranoid schizophrenia and twenty-two healthy volunteers paired with sex,age and education were scanned by ^1H-MRS. We got the metabolites of N-aeetyl aspartate （NAA）,choline-containing compounds （Cho）,creatine and phosphoereatine （Cr）,and the ratio of NAA/Cr,Cho/Cr through^ 1H-MRS data post-processing system. The ratio of NAA/Cr and Cho/Cr were statistically analyzed by t-test. Results：①Comparison in the case group：The NAA/Cr ratio was lower in the left frontal white matter of the patients as compared to the right side （P〈0.05）. The NAA/Cr and Cho/Cr ratio in the left head of the hippocampus was lower than that in the right side （P〈0.05）. There was no significant difference between the Cho/Cr ratio in the bilateral frontal white matter and the ratio of NAAICr,Cho/Cr in the bilateral anterior cingulated fascieulus in the case group （P〉0.05）. ②Comparison between the two groups：The NAA/Cr ratio in the left frontal white matter and the left head of hippoeampus was less in case group than in control group （P〈0.05）. There was no significant difference among the NAA/Cr ratio in the right frontal white matter,the right head of hippocampus,and the bilateral anterior cingulated fascieulus in case group and in control group （P〉0.05）. There was also no obvious difference among the Cho/Cr ratio in the bilateral frontal white matter,the bilateral head of hippocampus and the bilateral anterior cingulated fascieulus in case group and in control group （P〉0.05）. Conclusions：The neuron number or function is generally less in the left frontal white matter and the left head of hippocampus in first-episode patients with positive symptoms of schizophrenia, which indicates that brain biology function is ab- normal in these patients early,and supports the partial lateralization characteristics hypothesis of the cause in schizophrenia.