抑郁症患者局部脑血流变化的SPECT研究  

Research on cerebral blood flow in patients with depressive disorder using SPECT

作　　者：徐伊 [1] 徐浩 [2] 贾艳滨 [1] 徐安定 [1] 

机构地区：[1]暨南大学附属第一医院精神心理科,广州,510632 [2]暨南大学附属第一医院核医学科,广州,510632

出　　处：《中国神经精神疾病杂志》2005年第3期206-209,i014,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省医学科研基金项目资助[编号:粤卫(2002)119号A2002339]

摘　　要：目的用SPECT测定抑郁症患者的局部脑血流(rCBF),比较乙酰唑胺脑负荷试验后脑血流灌注变化,观察抑郁症患者脑血管的调节能力,以及是否存在潜在缺血灶。方法以18例未经抗抑郁治疗的抑郁症患者为研究对象,19名正常人作为对照组,行单光子发射计算机断层扫描(SPECT)检查。抑郁症患者48h后口服乙酰唑胺2g,再行SPECT检查。观察服用乙酰唑胺前后脑内血流的变化。结果抑郁组患者双侧额叶、颞叶的rCBF显著下降(P<0.01～0.05),左顶叶、右基底节rCBF也明显降低(P<0.05);同时,抑郁症患者局部脑血流低灌注存在不对称性,左侧灌注更低。服用乙酰唑胺后,原脑内各血流灌注下降部位恢复正常血供,未发现潜在缺血病灶。结论抑郁症患者某些特定部位存在脑血流灌注下降;乙酰唑胺脑负荷SPECT试验未发现抑郁症患者存在潜在缺血部位,而且使其局部脑血流低灌注状态恢复正常。Objective Using SPECT to observe the regional cerebral blood flow (rCBF), in patients with depressives disorders; and to observe the cerebral vasoreactivity via acetazolamide SPECT stress test in patients with depressive disorder. Methods Eighteen unmedicated patients fulfilling the CCMD-3 criteria for depressive disorder and nineteen healthy control subjects were included. Baseline SPECT was performed in both patients and control subjects. Acetazolamide SPECT stress test was performed 2 days later in patients 2 h after taking 2g acetazolamide orally. We observed the changes of the regional cerebral blood flow before and after acetazolamide SPECT rCBF stress test. Results We found significant differences between the untreated depressed patients and those of the controls, indicating relatively reduced perfusion in frontal lobe, temporal lobe, left pariental lobe, right basal ganglia in depressed patients. Additionally, we observed a significant asymmetry in perfusion between the left and right frontal、temporal and pariental cortical regions of the patients. There was a lower perfusion in the left side. After acetazolamide SPECT stress test the perfusion of decreased regions in baseline step were increased. Conclusions Acetazolamide SPECT stress test could not find out silent brain ischemia in depressed patients; The perfusion of decreased regions in the baseline imaging were increased in acetazolamide SPECT stress test.

关 键 词：抑郁症 局部脑血流 单光子发射计算机断层扫描 乙酰唑胺 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]