CAJ | 학술논문

目的探讨精神分裂症患者前额叶和丘脑的氢质子磁共振波谱(1H-MRS)特点及相关影响因素.方法以符合中国精神障碍分类与诊断标准(CCMD-3)的159例精神分裂症患者(患者组)为研究对象,并以45名正常人为对照(对照组).所有受试者在入组后采用多体素1H-MRS检测前额叶和丘脑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,并进行比较分析.患者组在入组时进行阳性和阴性症状量表(PANSS)、社会功能缺陷量表(SDSS)、威斯康星卡片分类测验(WCST)检测,分别评定患者的临床症状、社会功能和执行功能.结果患者组左侧前额叶、左侧丘脑和右侧丘脑NAA/Cr值分别为(1.42±0.34)、(1.46±0.35)、(1.49 ±0.34),均低于对照组(t值分别为3.70,3.32,2.04,P＜0.01或0.05).多元逐步回归分析显示,影响左侧前额叶NAA/Cr值的主要因素是发病年龄、病程、阴性症状分、服药情况、PANSS总分、WCST完成分类数、SDSS总分、受教育年限;影响左侧丘脑NAA/Cr值的主要因素是发病年龄、病程、服药情况;影响右侧丘脑NAA/Cr值的主要因素是病程、发病年龄、阴性症状分、服药情况、家族史.结论精神分裂症患者前额叶和丘脑神经元代谢异常的影响因素涉及多个方面,其中发病年龄、病程、抗精神病药物的影响明显.
목적 탐토정신분렬증환자전액협화구뇌적경질자자공진파보(1H-MRS)특점급상관영향인소.방법 이부합중국정신장애분류여진단표준(CCMD-3)적159례정신분렬증환자(환자조)위연구대상,병이45명정상인위대조(대조조).소유수시자재입조후채용다체소1H-MRS검측전액협화구뇌N-을선기천문동안산(NAA)、담감복합물(Cho)여기산복합물(Cr),완성NAA/Cr치、Cho/Cr치적계산,병진행비교분석.환자조재입조시진행양성화음성증상량표(PANSS)、사회공능결함량표(SDSS)、위사강성잡편분류측험(WCST)검측,분별평정환자적림상증상、사회공능화집행공능.결과 환자조좌측전액협、좌측구뇌화우측구뇌NAA/Cr치분별위(1.42±0.34)、(1.46±0.35)、(1.49 ±0.34),균저우대조조(t치분별위3.70,3.32,2.04,P＜0.01혹0.05).다원축보회귀분석현시,영향좌측전액협NAA/Cr치적주요인소시발병년령、병정、음성증상분、복약정황、PANSS총분、WCST완성분류수、SDSS총분、수교육년한;영향좌측구뇌NAA/Cr치적주요인소시발병년령、병정、복약정황;영향우측구뇌NAA/Cr치적주요인소시병정、발병년령、음성증상분、복약정황、가족사.결론 정신분렬증환자전액협화구뇌신경원대사이상적영향인소섭급다개방면,기중발병년령、병정、항정신병약물적영향명현.
Objective To explore the metabolite status on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) and affecting factors in patients of schizophrenia.Methods 159 schizophrenics met with CCMD-3 and 45 normal controls were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS.The N-acetylaspartate ( NAA),Choline-congtaining compounds ( Cho),and Creatine compounds (Cr)were measured and the ratios of NAA/Cr,Cho/Cr were determined. Positive and Negative Syndrome Scale (PANSS),Social Disability Screening Schedule (SDSS),and Wisconsin Card Sorting Test (WCST) were also assessed.Results On left prefrontal lobe of patients,the NAA/Cr ratio demonstrated lower than that in normal controls (1.42 ±0.34 vs.1.64 ±0.39,t =3.70,P＜0.01 ).The same phenomenon were appeared on left thalamus (1.46±0.35 vs.1.66±0.38,t=3.32,P＜0.01) and on right thalamus (1.49±0.34 vs.1.62±0.37,t=2.04,P ＜ 0.05 ).Contributing to the NAA/Cr ratio,main influencing factors on left prefrontal lobe were age of onset,duration of illness,score of negative symptoms,antipsychotic treatment,total score of PANSS,Categories completed of WCST,total score of SDSS,year of education.Main influencing factors on left thalamus were age of onset,duration of illness,antipsychotic treatment.Main influencing factors on right thalamus were duration of illness,age of onset,score of negative symptoms,antipsychotic treatment,and family history.Conclusions Abnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus in schizophrenics are related to many respects,especially age of onset,duration of illness and antipsychotic treatment.