海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2015年
12期
1748-1750
,共3页
磁共振波谱成像%扩散张量成像%重复经颅磁刺激%卒中后抑郁
磁共振波譜成像%擴散張量成像%重複經顱磁刺激%卒中後抑鬱
자공진파보성상%확산장량성상%중복경로자자격%졸중후억욱
Magnetic resonance spectroscopy (MRS)%Diffusion tensor imaging (DTI)%Repetitive transcrani-al magnetic stimulation%Post-stroke depression
目的:探讨磁共振波谱成像(MRS)及扩散张量成像(DTI)用于评价重复经颅磁刺激治疗卒中后抑郁疗效的价值。方法将40例脑卒中后抑郁患者根据随机数表法分为观察组和对照组各20例,另选择20例作为健康志愿者。对照组应用文拉法辛治疗,150 mg/d,缓释片顿服。观察组给予文拉法辛合并重复经颅磁刺激(rTMS)治疗。比较两组患者治疗前后的汉密尔顿抑郁量表(HAMD)评分、MRS、DTI指标的变化及其与健康志愿者的差异。结果(1)治疗后,两组患者的HAMD评分均明显降低,且观察组患者改善更显著,差异均具有统计学意义(P<0.05);(2)治疗前,两组患者的额叶、颞叶及基底节区各向异性分数(FA)值均明显低于健康志愿者,差异均具有统计学意义(P<0.05)。治疗后10 d,观察组额叶及颞叶FA值明显升高,与治疗前及对照组比较差异均具有统计学意义(P<0.05);(3)治疗前,两组额叶、颞叶及基底节区NAA/(Cho+Cr)、NAA/Cr值均明显低于健康志愿者,Cho/Cr显著高于健康志愿者,差异均具有统计学意义(P<0.05)。治疗后10 d,观察组额叶及颞叶NAA/(Cho+Cr)、NAA/Cr值明显升高,Cho/Cr明显降低,与治疗前及对照组比较差异均具有统计学意义( P<0.05)。结论重复经颅磁刺激治疗卒中后抑郁疗效可靠,应用MRS及DTI可以对其进行评价。
目的:探討磁共振波譜成像(MRS)及擴散張量成像(DTI)用于評價重複經顱磁刺激治療卒中後抑鬱療效的價值。方法將40例腦卒中後抑鬱患者根據隨機數錶法分為觀察組和對照組各20例,另選擇20例作為健康誌願者。對照組應用文拉法辛治療,150 mg/d,緩釋片頓服。觀察組給予文拉法辛閤併重複經顱磁刺激(rTMS)治療。比較兩組患者治療前後的漢密爾頓抑鬱量錶(HAMD)評分、MRS、DTI指標的變化及其與健康誌願者的差異。結果(1)治療後,兩組患者的HAMD評分均明顯降低,且觀察組患者改善更顯著,差異均具有統計學意義(P<0.05);(2)治療前,兩組患者的額葉、顳葉及基底節區各嚮異性分數(FA)值均明顯低于健康誌願者,差異均具有統計學意義(P<0.05)。治療後10 d,觀察組額葉及顳葉FA值明顯升高,與治療前及對照組比較差異均具有統計學意義(P<0.05);(3)治療前,兩組額葉、顳葉及基底節區NAA/(Cho+Cr)、NAA/Cr值均明顯低于健康誌願者,Cho/Cr顯著高于健康誌願者,差異均具有統計學意義(P<0.05)。治療後10 d,觀察組額葉及顳葉NAA/(Cho+Cr)、NAA/Cr值明顯升高,Cho/Cr明顯降低,與治療前及對照組比較差異均具有統計學意義( P<0.05)。結論重複經顱磁刺激治療卒中後抑鬱療效可靠,應用MRS及DTI可以對其進行評價。
목적:탐토자공진파보성상(MRS)급확산장량성상(DTI)용우평개중복경로자자격치료졸중후억욱료효적개치。방법장40례뇌졸중후억욱환자근거수궤수표법분위관찰조화대조조각20례,령선택20례작위건강지원자。대조조응용문랍법신치료,150 mg/d,완석편돈복。관찰조급여문랍법신합병중복경로자자격(rTMS)치료。비교량조환자치료전후적한밀이돈억욱량표(HAMD)평분、MRS、DTI지표적변화급기여건강지원자적차이。결과(1)치료후,량조환자적HAMD평분균명현강저,차관찰조환자개선경현저,차이균구유통계학의의(P<0.05);(2)치료전,량조환자적액협、섭협급기저절구각향이성분수(FA)치균명현저우건강지원자,차이균구유통계학의의(P<0.05)。치료후10 d,관찰조액협급섭협FA치명현승고,여치료전급대조조비교차이균구유통계학의의(P<0.05);(3)치료전,량조액협、섭협급기저절구NAA/(Cho+Cr)、NAA/Cr치균명현저우건강지원자,Cho/Cr현저고우건강지원자,차이균구유통계학의의(P<0.05)。치료후10 d,관찰조액협급섭협NAA/(Cho+Cr)、NAA/Cr치명현승고,Cho/Cr명현강저,여치료전급대조조비교차이균구유통계학의의( P<0.05)。결론중복경로자자격치료졸중후억욱료효가고,응용MRS급DTI가이대기진행평개。
Objective To investigate the value of magnetic resonance spectroscopy (MRS) and diffusion ten-sor imaging (DTI) for evaluating the effect of repetitive transcranial magnetic stimulation in the treatment of post-stroke depression. Methods Forty patients with post-stroke depression were randomly divided into observation group (20 cases) and control group (20 cases). Twenty healthy volunteers were selected as healthy control group. The control group was treated with Vin Rafa Sin treatment (150 mg/d) and sustained-release tablets orally. The observation group was given venlafaxine combined with repetitive transcranial magnetic stimulation (rTMS) treatment. Changes before and after treatment in HAMD score, MRS, DTI indexes were compared between the observation group and con-trol group, and also with healthy control group. Results (1) After treatment, HAMD scores in the observation group and control group were significantly decreased, and the improvement in the observation group was more significant (P<0.05). (2) Before treatment, fractional anisotropy (FA) values of frontal lobe, temporal lobe and basal ganglia in the observation group and control group were significantly lower than those in healthy control group, and the differenc-es were statistically significant (P<0.05). 10 d after treatment, FA values of frontal and temporal lobe in the observa-tion group were significantly increased, showing statistically significant difference with those before treatment and those in the control group (P<0.05). (3) Before treatment, NAA/(Cho+Cr), NAA/Cr of frontal lobe, temporal lobe and basal ganglia in the observation group and control group were significantly lower than those in healthy control group, while Cho/Cr was significantly higher (P<0.05). 10 d after treatment, NAA/(Cho+Cr), the NAA/Cr values of the fron-tal and temporal lobes in the observation group increased significantly, and Cho/Cr reduced significantly, showing sta-tistically significant difference with those before treatment and those in the control group (P<0.05). Conclusion Re-petitive transcranial magnetic stimulation has reliable curative effect on post-stroke depression, and MRS and DTI can evaluate the effect well.