单向抑郁患者中脑中缝核回声性改变与抑郁严重程度的相关性研究

Correlation between echogenicity of mesencephalon raphe nuclei and depression severity in unidimensionally depressed patients

目的分析抑郁发作患者中脑中缝核回声性改变与抑郁严重程度之间的相关性。方法选择已经确诊抑郁发作患者60例作为抑郁发作组(其中15例为有自杀意念的重度抑郁症患者,45例为无自杀意念的抑郁症患者),其中男性24例,女性36例;年龄18~62岁,平均年龄34.95岁;病程1~42年,平均病程13.37年。同期证实无患病的健康人群60例为健康对照组,其中男性23例,女性37例;年龄18~58岁,平均年龄27.07岁。根据汉密尔顿抑郁量表-17项(HAMD-17)评分标准,抑郁发作患者被分为3组。所有患者均进行中脑中缝核经颅超声检查,对其进行半定量评分分级,分析两组间中脑中缝核异常发生率,中脑中缝核回声改变、中缝核回声级别与抑郁严重程度的相关性。结果抑郁发作组较健康对照组中脑中缝核异常发生率显著增高,差异有显著统计学意义(80.00%vs 11.67%。P<0.01);抑郁发作患者自杀意念组与无自杀意念组中脑中缝核回声改变比较,差异无统计学意义(P>0.05)。轻度抑郁患者中脑中缝核回声强度分级Ⅰ度0例,Ⅱ度25例,Ⅲ度9例;中度抑郁患者中脑中缝核回声强度分级Ⅰ度4例,Ⅱ度9例,Ⅲ度3例;重度抑郁患者中脑中缝核回声强度分级Ⅰ度8例,Ⅱ度2例,Ⅲ度0例。中脑中缝核的回声可见度与抑郁症的严重程度呈负相关,差异有统计学意义(r=-0.562,P<0.05)。结论经颅超声探查抑郁发作患者的中脑中缝核回声异常,可为抑郁患者的辅助诊断及判断抑郁严重程度提供有价值的神经影像学信息。

Objective To analyze the correlation between echogenicity of mescencephalon raphe nuclei(RN)and depression severity in patients with unidimensionally depression.Methods A total of 60 patients with depression were enrolled as de pression group(15 patients with severe depression with suicidal ideation and 45 with depression non-suicidal ideation),which included 24 males and 36 females,aged 18-62 years old with mean age of 34.95 years old;course of disease was 1-42years with mean of 13.37 years.Sixty healthy were enrolled as healthy control group,which included 23 males and 37 females,aged 18-58 years old with mean age of 27.07 years old.According to the Hamilton Depression Rating Scale-17(HAMD-17),patients with depression were divided into 3 groups.All patients performed transcranial ultrasound(TCS)examination of RN for semi-quantitative scoring and grading.The correlation between incidence of abnormal RN,RN echo changes,RN echo level and severity of depression in 2 groups were analyzed.Results The incidence of abnormal RN in depression group was statistically significantly higher than that in healthy control group(80.00%vs 11.67%.P<0.01).There was no significant difference in RN echo changes between suicidal ideation group and non-suicidal ideation group(P<0.05).In patients with mild depression,the RN echo intensity was graded as gradeⅠin 0 case,gradeⅡin 25 and gradeⅢin 9.In patients with moderate depression,gradeⅠin 4 cases,gradeⅡin 9 and gradeⅢin 3.In patients with severe depression,gradeⅠin 8cases,gradeⅡin 2 and gradeⅢin 0.The echogenic visibility of RN was significantly negatively correlated with severity of depression(r=-0.562,P<0.05).Conclusion It is demonstrated that abnormal echogenicity of RN detected by TCS in patients with depressive episodes could provide valuable neuroimaging information for auxiliary diagnosis and judgment severity de-pression in patients with depression.