抑郁症患者神经细胞18F-FDG摄取代谢的PET/CT差异分析

Differences in brain neurons 18F-FDG uptake and metabolism through PET/CT in patients with depression

目的分析PET/CT测定首发与复发抑郁症患者脑区神经细胞18F-氟代脱氧葡萄糖(18F-FDG)摄取代谢的差异,研究这两种抑郁症患者的发病机制。方法选取首发抑郁症患者(首发组)和复发抑郁症患者(复发组)各25例,同时选择同时期30例健康志愿者,分析PET/CT测定首发和复发抑郁症患者脑区神经细胞18F-FDG摄取代谢的差异。结果首发组与复发组双侧额叶扣带回、左侧纹状体、双侧海马、右侧丘脑的葡萄糖摄取均低于正常人,这表明此为两种抑郁症重叠的摄取差异脑区;复发组重叠的摄取差异脑区的葡萄糖代谢清除率均低于首发组,尤其在左侧额叶扣带回与左侧海马的60~80 min、60~100 min清除率低于首发组(P<0.05)。结论采用PET/CT发现首发与复发抑郁症患者的18F-FDG摄取代谢存在部分差异,复发抑郁症患者尤其在左侧额叶扣带回与左侧海马的60~80 min、60~100 min清除率较低,这可能揭示了抑郁症患者复发的发病机制。

Objective To investigate the differences in 18 F-FDG uptake and metabolism of brain neurons through PET/CT in patients with first-episode and relapsed depression,and to explore the pathogenesis of these two kinds of depressive patients.Methods 25 patients with firs-episode depression(first-episode group),25 patients with recurrent depression(recurrent group)and 30 healthy controls(control group)were selected.PET/CT was used to analyze the differences in brain neurons 18 F-FDG uptake and metabolism between patients with firs-episode depression and recurrent depression.Results The incidences of glucose uptake in left frontal lobe,left striatum,bilateral hippocampus and right thalamus in both first-episode group and recurrent group were significantly lower than those in control group,suggesting that these were overlap uptake difference brain areas for these two kinds of depressions.The glucose metabolism clearance rates in overlap uptake difference brain areas in recurrent group were all significantly lower than those in first-episode group;especially clearance rates of 60~80 min in left frontal cingulate gyrus and 60~100 min in left hippocampus were significantly lower than those in first-episode group(P<0.05).Conclusion There exist some differences in 18 F-FDG uptake and metabolism in patients with first-episode and relapsed depression by PET/CT.In patients with recurrent depression,clearance rates of 60~80 min in left frontal cingulate gyrus and 60~100 min in left hippocampus are lower,which may reveal the pathogenesis of relapse in patients with depression.