精神分裂症患者海马磁共振质子波谱变化特点及临床意义

Change Characteristics and Clinical Significance of Hippocampal Magnetic Resonance Spectroscopy in Patients with Schizophrenia

目的:探究精神分裂症患者海马磁共振质子波谱(magnetic resonance spectroscopy,MRS)变化特点及临床意义。方法:选取2019年10月-2021年4月福建省福州神经精神病防治院接收的60例精神分裂症患者作为研究对象。所有患者均行氯丙嗪治疗,所有患者均于治疗前后行阳性与阴性症状量表评估、MRI检查及海马MRS检测、P300检测。分析治疗前后靶刺激潜伏期P2、P3及靶刺激波幅P2、P3,非靶刺激潜伏期P2及非靶刺激波幅P3。分析不同疗效患者左右侧海马N-乙酰基天门冬氨酸(N-acetylaspartate,NAA)/肌酸(creatine,Cr)、胆碱(choline,Cho)/Cr值。结果:治疗后靶刺激潜伏期P2、P3及非靶刺激潜伏期P2均有所降低,靶刺激波幅P2、P3,非靶刺激波幅P3均有所提升(P<0.05)。显效患者左右侧海马NAA/Cr值高于有效、无效患者,且有效患者NAA/Cr值高于无效患者(P<0.05);显效、有效、无效患者左右侧海马Cho/Cr值比较差异均无统计学意义(P>0.05)。结论:精神分裂症患者海马MRS变化特点显著,且变化与临床疗效关联密切,可通过海马MRS监测评估精神分裂症患者治疗效果,为后续治疗方案变革提供参考依据。

Objective:To explore the change characteristics and clinical significance of hippocampal magnetic resonance proton spectroscopy(MRS)in patients with schizophrenia.Method:A total of 60 patients with schizophrenia admitted to Fuzhou Neuropsychiatric Hospital in Fujian Province from October 2019 to April 2021 were selected as the research objects.All patients were treated with Chlorpromazine.All patients underwent positive and negative symptom scale assessment,MRI examination,hippocampal MRS and P300 examination before and after treatment.Target stimulation latency P2,P3 and target stimulation amplitude P2,P3,non-target stimulation latency P2 and non-target stimulation amplitude P3 were analyzed before and after treatment.The values of N-acetylaspartate(NAA)/creatine(Cr)and choline(Cho)/Cr in left and right hippocampus of patients with different therapeutic effects were analyzed.Result:After treatment,the target stimulation latency P2,P3 and non-target stimulation latency P2 decreased,and the target stimulation amplitude P2,P3 and non-target stimulation amplitude P3 increased(P<0.05).The NAA/Cr values in the left and right hippocampus of the markedly effective patients were higher than those of the effective and ineffective patients,and the NAA/Cr values of the effective patients was higher than that of the ineffective patients(P<0.05);there was no significant difference in Cho/Cr values between the left and right hippocampus in the markedly effective,effective,ineffective patients(P>0.05).Conclusion:The changes characteristics of hippocampal MRS in schizophrenic patients are significant,and the changes are closely related to the clinical efficacy.The treatment effect of schizophrenic patients can be evaluated through hippocampal MRS monitoring,so as to provide a reference for the follow-up treatment plan reform.