强迫症与抑郁症脑单光子发射计算机断层扫描对照研究  

Comparative study of single photo emission computed tomography between patients with obsessive-compulsive disorder and depressive disorder

作　　者：李峥[1] 李幼辉[1] 刘保平[2] 郭慧荣[1] 陆刚[1] 

机构地区：[1]郑州大学第一附属医院精神医学科,河南郑州450052 [2]郑州大学第一附属医院核医学科,河南郑州450052

出　　处：《临床荟萃》2008年第11期772-774,共3页Clinical Focus

基　　金：河南省卫生厅科技攻关项目(200703056)

摘　　要：目的探讨强迫症(OCD)、抑郁症局部脑血流量(regional cerebral blood flow,rCBF)特点。方法应用单光子发射计算机断层扫描(single photon emission computed tomography,SPECT)技术,对首发且未经治疗的22例OCD患者、20例抑郁症患者和19例正常人于静息状态下行脑血流显像。以小脑皮质的放射性计数值为参考,对局部脑血流进行半定量分析。结果OCD组脑灌注值(radioactivity rate,RAR)在双侧前额叶、前颞叶均高于正常组,分别为:强迫症组94.4±6.4,99.8±6.6,91.6±6.1,92.6±6.6;正常组88.1±7.3,86.9±8.9,84.0±7.2,83.4±7.2;差异均有统计学意义(均P<0.01)。抑郁症组灌注值在两侧前额叶、枕叶、扣带回及右侧前颞叶、顶叶分别为79.4±7.1,77.9±6.3,89.5±9.7,89.2±10.2;85.1±6.4,84.3±6.3;75.4±7.5;84.1±7.5;低于正常组的灌注值:88.1±7.3,86.9±8.9;97.7±11.2;96.2±8.4,95.4±8.7;83.4±7.2;92.4±9.4;差异均有统计学意义(P<0.01或P<0.05)。结论与正常对照组比,OCD组的前额叶及前颞叶呈高灌注改变;抑郁症组脑血流普遍低灌注;SPECT技术可望作为二者鉴别诊断的客观依据之一。Objective To explore the regional cerebral blood flow （rCBF） characteristics in patients with obsessive-compulsive disorder （OCD） and depressive disorder. Methods ^99m Tc-ECD brain single photon emission computed tomography（SPECT） imaging was performed in 22 untreated OCD patients,20 untreated depressive disorder patients,and compared with 19 normal controls. Results Comparied to normal controls, the patients with OCD demonstrated significantly higher radioactivity rate（RAR） in bilateral prefrontal lobes and anterior temporal lobes. In OCD,the RARs were 94.4±6.4,99.8±6.6,91.6±6.1,92.6±6.6;and in normal controls, RARs were 88.1± 7.3, 86.9±8.9,84.0±7.2,83.4±7.2 （all P〈0.01）. The depressive patients were demonstrated lower RAR in bilateral prefrontal lobes, cingulate gyrus, occipital lobes and right temporal lobe, parietal lobe. In the depressed, RARs were 79.4±7.1,77.9±6.3,89.5±9.7,89.2±10.2;85.1±6.4,84.3±6.3;75.4±7.5;84.1±7.5;and in normals, RARs were 88.1±7.3,86.9±8.9;97.7±11.2;96.2±8.4,95.4±8.7;83.4±7.2;92.4±9.4（P〈0.01 or P〈0.05）. Conclusion There are higher rCBF value in frontal lobe and temporal lobe in OCD. There are lower rCBF nearly in the whole cortex in depressive disorder. The cerebral blood perfusion in OCD is different from depressive disorder. Brain SPECT imaging may be the evidence for distinguishing OCD with depressive disorder.

关 键 词：强迫症性障碍 抑郁症 体层摄影术 发射型计算机 单光子 局部脑血流 

分 类 号：R947.77[医药卫生—药剂学]