强迫症患者^(99m)锝-双半胱乙酯脑显像特点及临床相关研究  

^(99m)Tc-ECD cerebral blood perfusion imaging in patients with obsessive-compulsive disorder and related study.

作　　者：李幼辉[1] 李峥[1] 郭慧荣[1] 曹素霞[1] 宋学勤[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

出　　处：《精神医学杂志》2009年第4期247-250,共4页Journal of Psychiatry

基　　金：河南省科技攻关项目(编号:200703056)

摘　　要：目的探讨强迫症患者的脑灌注特点,分析其与认知损害及临床特点间的关系。方法对39例首发且未经治疗的强迫症患者行单光子发射计算机断层扫描(SPECT)脑显像、威斯康星(WCST)认知功能测查及耶鲁-布朗强迫量表(Y-BOCS)评定临床特点。结果(1)强迫症组与正常对照组比较,强迫症组的双侧前额叶、前颞叶的RAR值分别为(94.4±6.1,99.8±6.4,91.6±6.1,92.8±6.6),高于正常对照组(88.3±7.1,86.9±7.9,84.0±7.2,84.4±7.3),差异有统计学意义(t=6.78,11.93,7.15,9.40;P值均<0.05)。(2)脑灌注与威斯康星结果的相关分析:右前额叶血流灌注与正确数成负相关(r=-0.783,P=0.014),右前颞叶血流灌注与错误数成正相关(r=0.384,P=0.047),右前额叶、左丘脑血流灌注与持续错误数成正相关(r=0.511,0.610;P=0.041,0.049)。(3)强迫症组双侧前额叶、右侧前颞叶的血流灌注与强迫思维成正相关(r=0.617,0.309,-0.358;P值均<0.05)。结论强迫症患者双侧前额叶、前颞叶的灌注存在明显增高现象。强迫症患者的右前额叶、左丘脑血流灌注异常与认知功能损害相关。强迫症患者的双侧前额叶、右侧前颞叶灌注与强迫思维程度成正相关,提示前额叶、右前颞叶的功能异常可能是强迫思维产生的脑功能基础。Objective To evaluate brain perfusion in patients with obsessive-compulsive disorder （OCD） and explore the relationship between cognitive dysfunction and clinic charactenstics. Methods Thirty-nine first-episode patients met with the criteria of ICD-10 for OCD were evaluated with cerebral blood perfusion imaging, Wisconsin Card Sorting Test （WCST） and Yale-Brown Obsessive-Compulsive Scale （Y-BOCS）. Results Compared to the normal controls, the patients demonstrated significantly higher RAR in bilateral anterior frontal and temporal lobes. The RAR in right prefrontal lobe was significantly negatively related with correct numbers （r=0. 783,=0. 014）, the RAR in right anterior temporal lobe was significantly positively with number of errors（r=0. 384, P：0. 047）, the RAR in right prefrontal lobe and left thalamus were significantly positively with number of persistent errors（r= 0.511, P= 0.041 ; r= 0.610, P=0.049）. The RAR in bilateral prefrontal lobes and anterior temporal lobes were significantly positively correlated with the scores of Y-BOCS（r=0. 617, 0. 309, --0. 358,P〈0.05）. Conclusion Patients with OCD show higher cerebral blood perfusion, mainly in bilateral prefrontal lobe and anterior temporal lobe. Right prefrontal lobe and left thalamus may be involved the process of cognition functive. The dysfunction of prefrontal lobe and right temporal cortex may be the cause of obsessions.

关 键 词：强迫症 局部脑血流 认知功能 临床症状 相关性 

分 类 号：R749.7[医药卫生—神经病学与精神病学]