CAJ | 학술논문

目的比较阴性与阳性症状为主的精神分裂症患者前额叶和丘脑质子波谱特点及差异.方法对58例阴性症状为主(阴性组)和51例阳性症状为主(阳性组)的精神分裂症患者,在入组后应用抗精神病药物治疗前采用多体素磁共振质子波谱(1H-MRS)检测双侧前额叶和丘脑N-乙酰基天门冬氨酸(NAA)、胆碱复合物(Cho)与肌酸复合物(Cr),完成NAA/Cr值、Cho/Cr值的计算,并进行对比分析.结果阴性组右侧丘脑NAA/Cr值(1.40±0.29)低于阳性组(1.62±0.33),阴性组的男性、女性、非首发、服药、未服药患者右侧丘脑NAA/Cr值分别低于阳性组相应的患者(均P＜0.05或0.01);阴性组的女性、非首发、未服药患者右侧丘脑Cho/Cr值高于阳性组相应的患者(P＜0.05).阴性组、阳性组左侧前额叶、左侧丘脑、右侧丘脑NAA/Cr值均与发病年龄负相关(P＜0.05或0.01),阴性组右侧丘脑Cho/Cr值与发病年龄正相关(r=0.25,P＜0.05);阴性组非首发、未服药患者右侧丘脑NAA/Cr值与病程负相关(r=0.48,P＜0.05),Cho/Cr值与病程正相关(r=0.58,0.56,P＜0.01).结论阴性症状为主的精神分裂症患者的右侧丘脑波谱异常相对明显,病程对波谱的影响更明显.
목적 비교음성여양성증상위주적정신분렬증환자전액협화구뇌질자파보특점급차이.방법 대58례음성증상위주(음성조)화51례양성증상위주(양성조)적정신분렬증환자,재입조후응용항정신병약물치료전채용다체소자공진질자파보(1H-MRS)검측쌍측전액협화구뇌N-을선기천문동안산(NAA)、담감복합물(Cho)여기산복합물(Cr),완성NAA/Cr치、Cho/Cr치적계산,병진행대비분석.결과 음성조우측구뇌NAA/Cr치(1.40±0.29)저우양성조(1.62±0.33),음성조적남성、녀성、비수발、복약、미복약환자우측구뇌NAA/Cr치분별저우양성조상응적환자(균P＜0.05혹0.01);음성조적녀성、비수발、미복약환자우측구뇌Cho/Cr치고우양성조상응적환자(P＜0.05).음성조、양성조좌측전액협、좌측구뇌、우측구뇌NAA/Cr치균여발병년령부상관(P＜0.05혹0.01),음성조우측구뇌Cho/Cr치여발병년령정상관(r=0.25,P＜0.05);음성조비수발、미복약환자우측구뇌NAA/Cr치여병정부상관(r=0.48,P＜0.05),Cho/Cr치여병정정상관(r=0.58,0.56,P＜0.01).결론 음성증상위주적정신분렬증환자적우측구뇌파보이상상대명현,병정대파보적영향경명현.
Objective To compare the differences between the schizophrenics with negative and positive symptoms on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy ( 1 H-MRS). Methods 58 negative subtype and 51 positive subtype schizophrenics were examined at prefrontal lobe and thalamus by multivoxel 1H-MRS before antipsychotic treatment The N-acetylaspartate (NAA), choline-containing compounds ( Cho), and creatine compounds (Cr) were measured and the ratios of NAA/Cr, Cho/Cr were determined. Results On right thalamus,the NAA/Cr ratio in negative subtype patients ( 1.40 ± 0.29 ) demonstrated lower than that in positive subtype ( 1.62 ± 0.33 ), the same phenomenon were appeared on male, female, non-first-episode, with-medicine and without-medicine patients (P ＜ 0.05 or 0.01 ). The Cho/Cr ratio on right thalamus in negative subtype of female,non-first-episode,without-medicine schizophrenics were lower than those in positive subtype (P ＜ 0.05 ).On left prefrontal lobe,left thalamus and right thalamus, the NAA/Cr ratios both in negative subtype and positive subtype schizophrenics were significantly negatively related with age of onset(P＜0. 05 or 0.01 ). In negative subtype schizophrenics,the Cho/Cr ratio on right thalamus was positively related with age of onset ( r = 0. 25, P ＜0.05 ). In negative subtype schizophrenics of non-first-episode, without-medicine, the correlation was negative between the NAA/Cr ratio and the course of disease( r= -0.48, -0.46, P＜0.05 ) ,and was positive between Cho/Cr ratio and the course of disease on right thalamus( r= 0.58,0.56, P＜ 0.01 ). Conlusion Compared with positive subtype schizophrenics,negative subtype schizophrenics have greater impairments on 1 H-MRS on right thalamus. The course of disease has greater effects on 1 H-MRS in negative subtype schizophrenics.