精神分裂症偏执型和双相Ⅰ型患者海马氢质子波谱研究  

Comparative study of proton magnetic resonance spectroscopy on the hippocampus between patients with paranoid schizophrenia and patients with bipolar mania

作　　者：崔立谦[1,2] 李涛[1] 蒋莉君[1] 邓伟[1] 黄朝华[1] 唐鹤菡[3] 龚启勇[3] 

机构地区：[1]四川大学华西医院精神医学研究室 [2]广州医学院第一附属医院心理科,广州510120 [3]四川大学华西医院临床磁共振研究中心

出　　处：《中国神经精神疾病杂志》2009年第6期355-358,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：国家杰出青年基金(编号:30125014)

摘　　要：目的比较精神分裂症偏执型和双相障碍I型躁狂发作患者海马代谢特点的异同。方法对符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的25例精神分裂症偏执型患者、20例双相I型躁狂发作患者和32名正常对照进行氢质子波谱扫描,检测双侧海马的N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌醇(mI)及肌酸(Cr)4种代谢产物,以Cr为参照物,分别计算双侧NAA/Cr、Cho/Cr及mI/Cr。统计方法采用多组间单因素方差分析及偏相关分析。结果精神分裂症组右侧海马Cho/Cr比正常对照组升高,差异有统计学意义(P<0.05),而两患者组的差异无统计学意义(P>0.05)。双相I型躁狂组左侧海马mI/Cr较精神分裂症组和正常对照组均升高,差异有统计学意义(P<0.05)。双相I型躁狂组左右海马NAA/Cr的单侧化指数与1.0相比差异无统计学意义(P>0.05)。偏相关分析显示两患者组的右侧海马NAA/Cr均与病程呈正相关(P<0.05)。结论精神分裂症偏执型患者可能存在右侧海马神经细胞膜损害;双相I型躁狂发作患者可能存在左侧海马神经细胞磷脂酰肌醇信号传导损害。Objective To compare biochemical characteristics of the hippocampal tissue between patients with paranoid schizophrenia and patients with bipolar mania by using proton magnetic resonance spectroscopy （ 1H MRS）. Methods The ratios of N-Acetylaspartate （ NAA）, choline and myoinositol to creatine （Cr） were measured using a 3.0 T GE Signa EXCITE MR system in 25 patients with paranoid schizophrenia, 20 patients with bipolar mania and 32 healthy subjects matched for age, gender, and years of education. ANOVA and partial correlation analysis were used for statistic process. Cerebral asymmetry of the hippocampal metabolism was also analyzed. Results In the right hippocampal regions, Cho/Cr ratio was significantly higher in patients with paranoid schizophrenia than in normal controls（ P 〈 0. 05 ）and Cho/Cr ratio was not different between two patient groups（ P 〉 0. 05 ）. In the left hippocampal regions, mI/Cr ratio was significantly higher in bipolar patients presented than in normal controls（ P 〈 0.05 ） and mI/Cr ratio was not different between two patient groups（P 〉 0. 05）. The lateralization index of NAA/Cr in the hippocampus region in bipolar patients had no significant difference compared with 1.0. Ratios of NAA/Cr in the right hippocampal regions positively correlated with the course of diseases in both schizophrenia and bipolar disorder groups. Conclusions Patients with paranoid schizophrenia may have membrane disturbance in the right hippocampus. Patients with bipolar mania may have the impairment of phosphatidyl inositol second messenger system in the left hippocampus.

关 键 词：精神分裂症 双相情感障碍 海马 磁共振氢质子波谱分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]