急性带状疱疹患者情感障碍及海马区细胞代谢变化研究

The study on affective disorder and cell metabolism changes in hippocampus in patients with acute herpes zoster

目的探讨急性期带状疱疹患者情感障碍发生率及双侧海马区细胞代谢变化。方法选取62例急性带状疱疹患者,1H-MRS检测患者双侧海马区细胞代谢,同时采用Hamilton抑郁量表(HAMD)、Hamilton焦虑量表(HAMA)、数字分级法(NRS)评估其抑郁、焦虑、疼痛强度,并分析其之间的相关性。结果12.9%(8/62)、21.0%(13/62)患者存在抑郁、焦虑障碍。合并焦虑/抑郁的带状疱疹患者右侧海马区Cho/Cr水平明显高于无合并焦虑/抑郁的患者,但右侧海马区NAA/Cr水平更低(P<0.05);合并焦虑/抑郁的急性带状疱疹患者病程、NRS评分明显高于无合并焦虑/抑郁的患者(P<0.01)。带状疱疹患者NRS评分、病程时长与HAMD、HAMA评分呈正相关。结论带状疱疹患者在急性期可出现抑郁/焦虑等情感障碍;病程越长、疼痛程度越重的患者更容易出现抑郁/焦虑障碍,且合并抑郁/焦虑的带状疱疹患者海马区细胞代谢变化更明显。

Objective To investigate the cell metabolism changes in bilateral hippocampus and the incidence of affective disorder in acute herpes zoster.Methods The magnetic resonance spectroscopy(1H-MRS)was used to detect the cell metabolism of bilateral hippocampus in 62 patients with acute herpes zoster from July 2020 to December 2021.The Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and Numerical Rating Scale(NRS)were used to evaluate their depression,anxiety and pain intensity,and the correlation between them was analyzed.Results 12.9%and 21.0%of acute herpes zoster had depression and anxiety disorders respectively.The level of Cho/Cr in the right hippocampus of herpes zoster patients with anxiety/depression was significantly higher than that of without anxiety/depression,but the level of NAA/Cr in the right hippocampus was lower(P<0.05).The duration of disease and NRS score of acute herpes zoster complicated with anxiety/depression were significantly higher than those without anxiety/depression(P<0.01).The NRS score and duration of disease in patients with herpes zoster were positively correlated with the score of HAMD and HAMA.Conclusion Patients with herpes zoster may have affective disorders such as depression/anxiety in the acute stage,the longer duration of disease and severe pain are more likely to have depression and anxiety disorder,and the changes of cell metabolism in hippocampus of herpes zoster patients with depression and anxiety are more obvious.