精神分裂症和抑郁症局部脑血流的变化

Changes in the regional cerebral blood flow in schizophrenia and depression detected with single photon emission computed tomography

目的 探讨单光子发射电子计算机断层显像扫描 (SPECT)在精神分裂症 (SC)与抑郁症 (DE)的临床诊断及脑部功能异常定位研究的价值。方法 采用SPECT技术 ,对首发、未服药的 2 7例精神分裂症及 12例抑郁症患者与 10例正常人于静息状态下行脑血流 (rCBF)显像研究。结果 以阳性症状为主SC、以阴性症状为主SC及DE患者rCBF异常的阳性率分别为 5 4.5 4%、75 .0 0 %、83.33%。rCBF异常均表现皮层内局限性放射性分布稀疏、缺损区。SC患者rCBF异常脑叶涉及范围较大 ,以颞叶、额叶、顶叶、枕叶为主 ,且额叶rCBF减低与阴性症状明显有关。DE患者rCBF减低仅局限在颞叶或额叶 ,且以左侧颞叶或额叶为主。结论 精神分裂症不同亚型和抑郁症患者的脑叶rCBF的异常各有其特点。SPECT脑显像对两种疾病的诊断及脑功能异常的定位研究均有重要的价值。

Objective To explore the role of single photon emission computed tomography (SPECT) in diagnosis and location of brain dysfunction in schizophrenia and major depression. Methods Regional cerebral blood flow (rCBF) of 39 patients (27 with schizophrenia and 12 with major depression) who suffered from the diseases and did not take medicine and 10 normal controls were examined by SPECT.The 27 patients with schizophrenia were tested with positive and negative syndrome (PANSS) and 12 patients with depression were tested with Homilton (HAMD). Results The positive rates of rCBF abnormality in positive symptom group of schizophrenia, negative symptom group of schizophrenia and depression group were 54.54%, 75.00% and 83.33%, respectively. The decrease of rCBF in patients with schizophrenia and depression was the main feature. The rCBF abnormality in schizophrenia group involved temporal, frontal, parietal lobes and there was a correlation between the reduction of rCBF in frontal and negative symptom of schizophrenia. The decrease of rCBF in patients with depression was in the temporal or frontal lobes and rCBF abnormality was mainly in the left brain. Conclusion There were different features in rCBF abnormality between subtypes of schizophrenia and depression. SPECT is very important in diagnosis and study of location of brain dysfunction in schizophrenia and depression.