强迫症患者局部脑血流灌注研究  

A study of regional cerebral blood flow in patients with obsessive-compulsive disorder.

作　　者：林雄标[1] 张英男 余常红[1] 郑溪园 张繁新[1] 杨志伟[1] 胡纪泽[1] 

机构地区：[1]深圳市康宁医院,深圳518020 [2]深圳市人民医院

出　　处：《中国神经精神疾病杂志》2005年第2期92-95,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：深圳市卫生科技计划项目 (编号 :2 0 0 2 0 4 2 0 2 )

摘　　要：目的　探讨强迫症(OCD)患者局部脑血流灌注(rCBF)特点及临床症状与rCBF的关系。方法　对2 8例符合国际疾病分类第1 0版(ICD 1 0 )强迫障碍诊断标准患者和1 5名正常人进行单光子发射计算机断层扫描(SPECT)脑显像分析。用耶鲁 布朗强迫评定量表(YBOCS)、Hamilton焦虑量表(HAMA)和Hamilton抑郁量表(HAMD)对患者临床症状进行评定。结果　OCD患者两侧丘脑、顶叶和基底神经节的平均放射性计数百分数(PMRC)显著高于正常组;右颞PMRC明显低于正常组;且正常组两侧颞叶和顶叶PMRC值差异非常显著。在强迫恐惧/洗涤、回避组,YBOCS强迫行为分量表评分与右基底PMRC显著正相关(r =0 .70 1 )。结论　OCD患者两侧丘脑、顶叶和基底神经节的血流灌注增加和功能亢进;右颞血流灌注减少和功能低下,两侧颞叶和顶叶血流灌注的不对称性与正常人显著不同,后者的不对称性非常显著;在强迫恐惧/洗涤、回避组,强迫行为与右基底节功能增强有关。Objective To investigate the regional cerebral blood flow (rCBF) and the relationship between the symptoms and rCBF in the untreated patients with obsessive-compulsive disorder (OCD). Methods Twenty-eight patients who were diagnosed as OCD according to ICD-10 were enrolled in the single-photon emission computed tomography (SPECT) study with fifteen healthy volunteers as controls. The clinical symptoms were rated with scales of YBOCS, HAMD and HAMA. Results Compared with normal controls, the percentage of mean radio count (PMRC) in the region of thalamus, parietal lobes and basal ganglia were significantly higher in the patients. The PMRC of the right temporal lobe were significantly lower in the patients. In normal controls the differences of the PMRC between the bilateral temporal lobes and parietal lobes are more remarkable than in OCD patients. In the patients with the behavioral of washing and phobic avoidance, the scores of compulsion subscales of YBOCS were correlated positively with the PMRC of the right basal ganglia. Conclusions The patients have increased blood flow and cell hyperactivity in the thalamus, parietal lobe and basal ganglia and decreased blood flow and cell dysfunction in the right temporal lobe. In normal controls, bilateral perfusion asymmetry was found at bilateral temporal lobes and bilateral parietal lobes. In the patients with symptoms of washing and phobic avoidance the compulsive behavior were correlated with right basal ganglia dysfunction.

关 键 词：强迫症 局部脑血流 单光子发射计算机断层扫描 

分 类 号：R749.7[医药卫生—神经病学与精神病学]