慢性阻塞性肺疾病患者焦虑与脑功能活动异常的相关性研究

Correlation between anxiety symptoms and abnormal brain function in chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病(COPD)患者长期慢性低氧状态下的焦虑症状与脑功能活动异常的相关性。方法前瞻性选择21例COPD合并焦虑患者为COPD组,并选取26例性别、年龄相匹配的健康人群为对照组。2组患者均行高分辨率3D-T1加权成像(3D-T1WI)、T2-液体衰减反转恢复(T2-FLAIR)及血氧水平依赖(BOLD)序列检查,应用DPARSF及SPM8软件对2组脑低频振幅(ALFF)值进行分析。结果COPD组患者左海马旁回-扣带回ALFF值增高,右额上回ALFF值减低,差异有统计学意义(P<0.05);Pearson相关性分析发现,右额上回ALFF值与焦虑评分呈负相关(r=-0.485,P=0.03)。结论COPD慢性低氧患者存在右额上回的脑功能活动损害,损害程度与焦虑症状呈正相关,并且可能存在海马旁回-扣带回的脑功能活动代偿性增强。

Objective To analyze the correlation between anxiety symptoms and abnormal brain function in patients with chronic obstructive pulmonary disease(COPD)under long-term chronic hypoxia.Methods Twenty-one patients with COPD complicated with anxiety were prospectively selected as COPD group,and 26 healthy individuals matched for gender and age were selected as control group.Both groups underwent high-resolution 3D-T1-weighted imaging(3D-T1WI),T2-fluid-attenuated inversion recovery(T2-FLAIR),and blood oxygen level dependent(BOLD)sequence examination.DPARSF and SPM8 software were used to analyze the amplitude of low-frequency fluctuations(ALFF)in the brain of the two groups.Results In the COPD group,the ALFF value in the left parahippocampal gyrus-cingulate gyrus increased,and the ALFF value in the right superior frontal gyrus decreased(P<0.05).Pearson correlation analysis found that there was a negative correlation between the ALFF value in the right superior frontal gyrus and the anxiety score(r=-0.485,P=0.03).Conclusion Chronic hypoxic patients with COPD have brain functional impairment in the right superior frontal gyrus,and the degree of impairment is positively correlated with anxiety symptoms.There may also be compensatory enhancement of brain function activity in the parahippocampal gyrus-cingulate gyrus.