临床精神医学杂志
臨床精神醫學雜誌
림상정신의학잡지
JOURNAL OF CLINICAL PSYCHOLOGICAL MEDICINE
2014年
3期
167-170
,共4页
躯体化障碍%磁共振波谱分析%生化物质
軀體化障礙%磁共振波譜分析%生化物質
구체화장애%자공진파보분석%생화물질
somatization disorder%magnetic resonance spectroscopy%biochemical metabolism
目的：探讨躯体化障碍患者与正常人脑区域生化物质代谢的差异以及与述情障碍的相关性。方法：采用磁共振波谱分析（MRS）方法，对25例躯体化障碍患者（患者组）和25名正常人（对照组）的左、右丘脑、尾状核进行 MRS 的多体素定位扫描，获得胆碱复合物（ Cho）、肌酸（Cr）、N-乙酰天门冬氨酸（NAA）的波峰下面积，并取相对值 NAA/ Cr、Cho/ Cr 值作为分析指标，进行组间、组内左右部位之间的数据分析。同时对两组进行多伦多述情障碍量表（TAS-20）的评定，将患者组有统计学差异的脑区NAA/ Cr 值与 TAS-20得分进行相关分析。结果：患者组与对照组丘脑 NAA、NAA/ Cr 值的组别效应（F ＝4.078，F ＝5.071）、左右侧效应（F ＝4.969，F ＝5.326）及交互效应（F ＝11.673，F ＝13.992）有统计学意义（P ﹤0.05或 P ﹤0.001）；患者组与对照组尾状核 NAA、NAA/ Cr 值组别效应有统计学意义（F ＝12.343，P ＝0.001；F ＝18.778，P ＝0.000）。患者组左侧丘脑 NAA/ Cr 值与 TAS-20评分呈负相关（r ＝-0.417，P ＝0.038）；左右尾状核 NAA/ Cr 值与 TAS-20评分无相关（ r ＝-0.240，P ＝0.248；r ＝-0.290，P ＝0.159）。结论：躯体化障碍患者左丘脑、左右尾状核存在生化物质代谢异常；其述情障碍与左丘脑生化物质代谢异常相关。
目的：探討軀體化障礙患者與正常人腦區域生化物質代謝的差異以及與述情障礙的相關性。方法：採用磁共振波譜分析（MRS）方法，對25例軀體化障礙患者（患者組）和25名正常人（對照組）的左、右丘腦、尾狀覈進行 MRS 的多體素定位掃描，穫得膽堿複閤物（ Cho）、肌痠（Cr）、N-乙酰天門鼕氨痠（NAA）的波峰下麵積，併取相對值 NAA/ Cr、Cho/ Cr 值作為分析指標，進行組間、組內左右部位之間的數據分析。同時對兩組進行多倫多述情障礙量錶（TAS-20）的評定，將患者組有統計學差異的腦區NAA/ Cr 值與 TAS-20得分進行相關分析。結果：患者組與對照組丘腦 NAA、NAA/ Cr 值的組彆效應（F ＝4.078，F ＝5.071）、左右側效應（F ＝4.969，F ＝5.326）及交互效應（F ＝11.673，F ＝13.992）有統計學意義（P ﹤0.05或 P ﹤0.001）；患者組與對照組尾狀覈 NAA、NAA/ Cr 值組彆效應有統計學意義（F ＝12.343，P ＝0.001；F ＝18.778，P ＝0.000）。患者組左側丘腦 NAA/ Cr 值與 TAS-20評分呈負相關（r ＝-0.417，P ＝0.038）；左右尾狀覈 NAA/ Cr 值與 TAS-20評分無相關（ r ＝-0.240，P ＝0.248；r ＝-0.290，P ＝0.159）。結論：軀體化障礙患者左丘腦、左右尾狀覈存在生化物質代謝異常；其述情障礙與左丘腦生化物質代謝異常相關。
목적：탐토구체화장애환자여정상인뇌구역생화물질대사적차이이급여술정장애적상관성。방법：채용자공진파보분석（MRS）방법，대25례구체화장애환자（환자조）화25명정상인（대조조）적좌、우구뇌、미상핵진행 MRS 적다체소정위소묘，획득담감복합물（ Cho）、기산（Cr）、N-을선천문동안산（NAA）적파봉하면적，병취상대치 NAA/ Cr、Cho/ Cr 치작위분석지표，진행조간、조내좌우부위지간적수거분석。동시대량조진행다륜다술정장애량표（TAS-20）적평정，장환자조유통계학차이적뇌구NAA/ Cr 치여 TAS-20득분진행상관분석。결과：환자조여대조조구뇌 NAA、NAA/ Cr 치적조별효응（F ＝4.078，F ＝5.071）、좌우측효응（F ＝4.969，F ＝5.326）급교호효응（F ＝11.673，F ＝13.992）유통계학의의（P ﹤0.05혹 P ﹤0.001）；환자조여대조조미상핵 NAA、NAA/ Cr 치조별효응유통계학의의（F ＝12.343，P ＝0.001；F ＝18.778，P ＝0.000）。환자조좌측구뇌 NAA/ Cr 치여 TAS-20평분정부상관（r ＝-0.417，P ＝0.038）；좌우미상핵 NAA/ Cr 치여 TAS-20평분무상관（ r ＝-0.240，P ＝0.248；r ＝-0.290，P ＝0.159）。결론：구체화장애환자좌구뇌、좌우미상핵존재생화물질대사이상；기술정장애여좌구뇌생화물질대사이상상관。
Objective:To study the differences of substance metabolism in brain regions between the pa-tients with somatization disorder and healthy volunteers and investigate the correlation between the substance metabolism and alexithymia. Method:By using magnetic resonance spectroscopy(MRS),the thalamus and caudate nucleus of 25 patients(patient group)with somatization disorder and 25 controls(control group)were scanned,then the level of choline complex(Cho),creatine(Cr)and N-acetyl aspartic acid(NAA)were esti-mated according to the area under the curve(AUC)respectively. And the ratios of NAA/ Cr and Cho/ Cr were compared within-subjects and between-subjects in left and right brain regions. Also Toronto alexithymia scale (TAS-20)was rated by patients and controls. Then the correlation between the ratio of NAA/ Cr which showed significant difference in some brain region of patients’and their TAS-20 scores were analyzed. Results:The between-subjects effects(F = 4. 078,F = 5. 071)and the within-subjects effects(F = 4. 969,F = 5. 326)and the interaction effects(F = 11. 673,F = 13. 992)between patients and controls’thalamus NAA,NAA/ Cr existed significant difference(P ﹤ 0. 05 or P ﹤ 0. 001). Moreover the between-subjects effects of NAA、NAA/ Cr between patients and controls’caudate nucleus existed statistical difference( F = 12. 343,P = 0. 001;F = 18. 778, P = 0. 000). The ratio of NAA/ Cr of patients’left thalamus was negatively correlated with their TAS-20 (r = - 0. 417,P = 0. 038),while the ratio of NAA/ Cr of bilateral caudate nucleus had no correlation with TAS-20(r = - 0. 240,P = 0. 248;r = - 0. 290,P = 0. 159). Conclusion:There were abnormal biochemical metab-olism in left thalamus and bilateral caudate nucleus of patients with somatization disorder. Their alexithymia is correlated to the abnormal biochemical metabolism in left thalamus.
