^(1)H-MRS评价精神分裂症幻听患者扣带回代谢物比值

^(1)H-MRS Evaluation of Cingulate Gyrus Metabolite Ratios in Schizophrenia Patients with Auditory Hallucinations

目的:基于^(1)H-MRS探讨精神分裂症幻听患者扣带回各代谢物比值改变。方法:精神分裂症患者30例,根据PANSS中P3值,分为无幻听组(P3值≤3分)15例和幻听组(P3值>3分)15例,另选择同期健康受试者15例为对照组。3组均行扣带回^(1)H-MRS扫描,比较3组扣带回的N-乙酰天门冬氨酸(NAA)/[胆碱复合物(Cho)+肌酸(Cr)]、NAA/Cr、NAA/Cho和Cho/Cr比值,分析精神分裂症幻听患者扣带回各代谢物比值与病程、发病年龄及幻听分值的相关性。结果:幻听组的NAA/(Cho+Cr)、NAA/Cr、NAA/Cho低于对照组(P<0.05)、无幻听组(P<0.05),且无幻听组以上指标均低于对照组(P<0.05);而3组间Cho/Cr相比无统计学意义(P>0.05)。扣带回NAA/(Cho+Cr)、NAA/Cr比值与幻听分值明显相关(P<0.05),Cho/Cr比值与幻听分值无相关性(P>0.05);NAA/(Cho+Cr)、NAA/Cr、NAA/Cho与发病年龄、病程无明显相关性(P>0.05);Cho/Cr与发病年龄相关(P<0.05),与病程、幻听分值无相关性(P>0.05)。结论:精神分裂症幻听患者扣带回存在显著的代谢异常,扣带回可能作为传导通路的一个环节,与幻听发生可能有密切的关系。

Objective:To observe metabolite ratio changes in cingulate gyrus of schizophrenia patients with auditory hallucinations using^(1)H-MRS.Methods:According to the P3 item score of the PANSS,30 schizophrenic patients were divided into non-auditory hallucination(NAH)group(P3≤3)and auditory hallucination(AH)group(P3>3)with 15 patients in each.And 15 healthy subjects were enrolled as control group.The N-acetylaspartic acid(NAA)/[choline complex(CHO)+creatine(CR)],NAA/Cr,NAA/CHO,and Cho/Cr ratio in the cingulate gyrus in the 3 groups were compared by^(1)H-MRS scanning.The correlation between the metabolite ratios in the cingulate gyrus of schizophrenia patients experiencing auditory hallucinations and the course of disease,age of onset,and auditory hallucinations score was analyzed.Results:NAA/(CHO+CR),NAA/Cr,and NAA/Cho in the AH group were significantly lower than those in the control group(P<0.05)and NAH group(P<0.05);furthermore,the indexes in the NAH group were all lower than those in the control group(P<0.05).There was no significant difference in CHO/Cr among the three groups(P>0.05).NAA/(CHO+CR)and NAA/Cr ratios in the cingulate gyrus were significantly correlated with auditory hallucination score(P<0.05),and the CHO/Cr ratio was not correlated with auditory hallucination score(P>0.05).NAA/(CHO+CR),NAA/Cr,and NAA/Cho were not correlated with age of onset and course of disease(P>0.05).CHO/Cr was correlated with age at onset(P<0.05)but not with course of disease and auditory hallucination score(P>0.05).Conclusion:Schizophrenia patients with auditory hallucinations have significant metabolic changes in the cingulate gyrus.The cingulate gyrus may serve as a link in the conductive pathway involved in the pathogenesis of auditory hallucination.