摘要
目的通过抑郁症患者基础和认知激活局部脑血流（ｒＣＢＦ）灌注显像的半定量分析，评估抑郁症患者的脑血流灌注异常。方法选择２７例未经抗抑郁治疗、ＩＣＤ１０分类为中度抑郁发作伴躯体症状的患者，１５例年龄匹配的健康人作正常对照。２７例患者中２１例、１５例健康人中１３例行双日法基础与认知激活脑ｒＣＢＦ显像；另６例患者及２例健康人仅行基础脑ＳＰＥＣＴ显像。认知激活采用Ｗｉｓｃｏｎｓｉｎ卡片分类试验。半定量分析在横断面图像７～１１帧上进行，将各ＲＯＩ的平均计数与同侧小脑的最高计数相除，得到各ＲＯＩ的ｒＣＢＦ比值。结果抑郁症左额叶和左颞叶的基础ｒＣＢＦ值均为０７２０，明显低于对照组（０７６４和０７５０，Ｐ＜００５）；左额、左颞、左顶叶的认知激活ｒＣＢＦ值分别为０７１９、０６９０及０７０１，明显低于对照组（０７８２、０７５２和０７６６，Ｐ＜００１和Ｐ＜００５）。结论①抑郁症患者存在左额叶、左颞叶的局部血流低灌注。②额叶、颞叶皮层低灌注可能是引起抑郁症认知障碍、心境低落的原因。
Purpose To evaluate the regional cerebral blood flow (rCBF) abnormalities through the semiquantitative analysis of the baseline and cognition activated rCBF imaging in unmedicated depressed patients Methods 27 depressed patients unmedicated by anti depressants were enrolled The diagnosis (depression of moderate degree with somatization) was confirmed by the ICD 10 criteria 15 age matched normal controls were studied under identical conditions Baseline and cognition activated 99m Tc ECD SPECT were performed on 21 of the 27 patients with depression and 13 of the 15 normal controls Baseline 99m Tc ECD SPECT alone were performed on the rest 6 patients with depression and 2 normal controls The cognitive activation is achieved by Wisconsin Card Sorting Test (WCST) 1110MBq of 99m Tc ECD was administered by intravenous bolus injection 5 minutes after the onset of the WCST Semi quantitative analysis was conducted with the 7th, 8th, 9th, 10th, 11th slices of the transaxial imaging rCBF ratios of every ROI were calculated using the average tissue activity in the region divided by the maximum activity in the cerebellum Results ①The baseline rCBF of left frontal (0 720) and left temporal lobe (0 720) were decreased significantly in depressed patients comparing with those of the control subjects ②The activated rCBF of left frontal lobe (0 719) and left temporal lobe (0 690), left porietal lobe (0 701) were decreased evidently than those of the controls Conclusions ①Hypoperfusions of left frontal and left temporal cortexes were identified in patients with depression ②The hypoperfusion of left frontal and left temporal cortexes may be the cause of cognition disorder and depressed mood in patients with depression ③Cognition activated brain perfusion imaging is helpful for making a more accurate diagnosis of depression
出处
《中华核医学杂志》
CAS
CSCD
北大核心
1998年第2期70-72,共3页
Chinese Journal of Nuclear Medicine
关键词
抑郁症
血流灌注异常
认知
SPECT
Depression Brain Tomography, emission computed, single photon Cognition
