急性脑卒中患者并发抑郁的~1H-MRS相关研究Relevant Study on ~1H-MRS with Acute Stroke Patients and Subsequent Post-Stroke Depression
黄侃,陈眉,许茂盛,裘涛,张伟骏
摘要(Abstract):
目的探索急性脑卒中患者脑氢质子磁共振波谱(1H-MRS)分析与卒中后抑郁(PSD)的早期相关性。方法选取符合要求的25例急性脑卒中患者分别于发病2周、1月及3月时采用汉密尔顿抑郁量表(HAMD-17)评价抑郁状态发生情况,并于卒中早期行双侧前额叶白质区及海马区1H-MRS扫描。根据随访结果,抑郁组、无抑郁组分别为13例及12例;正常对照组20例,额叶及海马区扫描各10例。分析各部位代谢物N-乙酰天门冬氨酸盐(NAA)/肌酸(Cr)、胆碱(Cho)/Cr及肌醇(mI)/Cr的比值变化。结果与对照组比较,抑郁组双侧前额叶白质区及海马区NAA/Cr比值明显降低,而Cho/Cr比值升高,且以左侧前额叶及海马区显著;与非抑郁组比较,抑郁组左侧Cho/Cr升高及左海马区NAA/Cr降低差异有统计学意义。结论 1H-MRS分析能在体反映脑组织中代谢物变化情况。急性脑卒中后,双侧前额叶白质区、海马区低NAA/Cr及高Cho/Cr比值预示其后发生PSD可能性较大,对脑卒中后是否并发抑郁障碍有一定判断价值。
关键词(KeyWords): 脑卒中;抑郁症;氢质子磁共振波谱;前额叶白质;海马
基金项目(Foundation): 浙江省中医药科技计划资助项目(2005A026)
作者(Author): 黄侃,陈眉,许茂盛,裘涛,张伟骏
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