强迫症患者局部脑血流灌注与认知功能特点  

Regional cerebral blood flow and cognitive function in patients with obsessive-compulsive disorder

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,郑州450052

出　　处：《郑州大学学报（医学版）》2010年第1期68-71,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省卫生厅科技攻关基金资助项目200703056

摘　　要：目的:探讨强迫症患者局部脑血流灌注和认知功能特点及2者的相关性。方法:应用单光子发射计算机断层扫描(SPECT)技术,对首发且未经治疗的39例强迫症患者(强迫症组)和39例正常人(正常对照组)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,计算各脑区放射性计数比值(RAR)。采用威斯康星卡片分类测查进行认知功能评定。结果:强迫症组的左、右侧前额叶、前颞叶和右枕叶的RAR值分别为(94.4±6.1)、(99.8±6.4)、(91.6±6.1)、(92.8±6.6)和(102.3±7.7),高于正常对照组的(88.3±7.1)、(86.9±7.9)、(84.0±7.2)、(84.4±7.3)和(96.4±10.2),差异有统计学意义(t=6.78、11.93、7.15、9.40和4.89,P均<0.05)。威斯康星分类测查中,强迫症组正确数、完成分类数的得分为(33.24±5.39)和(4.42±1.62),低于正常对照组的(38.15±4.64)和(5.72±0.94)(t=-3.657和-2.495,P均<0.05);在错误数和持续错误数上的得分为(13.21±6.89)和(6.79±4.89),高于正常对照组的(7.53±5.97)和(2.06±1.29)(t=5.881和4.873,P均<0.05)。右前额叶RAR与正确数呈负相关(r=-0.783,P=0.014),右前颞叶RAR与错误数呈正相关(r=0.384,P=0.047),右前额叶、左丘脑RAR与持续错误数呈正相关(r=0.511和0.610,P=0.041和0.049)。结论:强迫症患者双侧前额叶、前颞叶脑血流灌注存在明显增高现象;右侧额叶、颞叶及左丘脑与认知损害相关。Aim：To explore the relationship between regional cerebral blood perfusion and cognitive function in obsessive compulsive disorder（OCD） patients.Methods：Thirty-nine unmediated patients with OCD and thirty-nine controls were involved.All the subjects accepted cerebral blood perfusion imaging and Wisconsin Card Sorting Test（WCST）.Results：Compared with the normal controls,the patients demonstrated significantly higher RAR in both the right and the left anterior frontal lobe,temporal cortex.Left prefrontal lobe RAR in patients and in controls was were（94.4±6.1） and（88.3±7.1）（t=6.78,P=0.001）.Right prefrontal lobe RAR in patients and controls was（99.8±6.4） and（86.9±7.9）（t=11.93,P0.001）.Left anterior temporal RAR in patients and controls was（91.6±6.1） and（84.0±7.2）（t=7.15,P=0.002）.Right anterior temporal cortex RAR in patients and controls was（92.8±6.6） and（84.4±7.3）（t=9.40,P0.001）.Right occipital lobe RAR in patients and controls was（102.3±7.7） and（96.4±10.2）（t=4.89,P0.05）.In WCST,scores of correct numbers and classification numbers in patients [（33.24±5.39）,（4.42±1.62）] were lower than those of the controls [（38.15±4.64）,（5.72±0.94）];and scores of errors and persistent errors in patients [（13.21±6.89）,（6.79±4.89）] were higher than those of the controls [（7.53±5.97）,（2.06±1.29）]（t=-3.657,-2.495,5.881,4.873,P0.05）.The RAR in right prefrontal lobe was negatively correlated with the score of correct numbers（r=-0.783,P=0.014）;the RAR in right anterior temporal cortex was positively correlated with the score of errors（r=0.384,P=0.047）;the RAR in right prefrontal lobe and left thalamus were positively correlated with the score of persistent errors（r=0.511,P=0.041;r=0.610,P=0.049）.Conclusion：Patients with OCD show higher cerebral blood perfusion mainly in prefrontal lobe and temporal cortex,which may play important roles in the occurrence of OCD.Right prefrontal lobe,temporal cortex and

关 键 词：强迫症 局部脑血流 认知功能 

分 类 号：R947.77[医药卫生—药剂学]