单光子计算机断层扫描仪局部脑血流灌注显像用于抑郁症氟西汀治疗前后的对比观察  

SPECT Imaging in Effect Estimation of Antidepressant Treatment

作　　者：陈淮菁[1] 周芬莉[1] 邹文[1] 张海鸥[1] 易黎[1] 

机构地区：[1]北京大学深圳医院神经内科,广东深圳518036

出　　处：《华西医学》2010年第5期847-849,共3页West China Medical Journal

摘　　要：目的探讨单光子计算机断层扫描仪(SPECT)对抑郁症的疗效评估价值。方法 2006年5月2007年12月,选取32例未经治疗的原发性中、重度抑郁症患者,给予氟西汀治疗10周。治疗后根据临床疗效总评量表和汉密尔顿抑郁量表(HAMD)减分率作为疗效评定指标,将患者分为有效组21例,无效组11例。对所有患者于治疗前和治疗后分别进行99m锝-双半胱乙酯(99mTc-ECD)脑灌注显像。静脉注射99mTC-ECD1 110MBq,30min后行脑断层显像,对显像结果分别进行目测及半定量分析两种方法进行判断。结果抑郁症患者出现的脑血流灌注减低区主要集中在前额叶、扣带回,经过治疗后好转的抑郁症患者脑血流灌注明显改善。可通过脑血流灌注显像评估抗抑郁治疗的疗效,左前额叶血流灌注越低,对氟西汀治疗效果越好。结论 SPECT显像技术可视性较好,可用于评估抗抑郁治疗的疗效。Objective To estimate treatment effects of fluoxetine with SPECT imaging of regional cerebral blood flow in patients with depression. Methods Thirty-two patients with untreated primary moderate or severe depression,diagnosed during May 2006 to December 2007, were enrolled in this study. They were treated with fluoxetine for ten weeks. According to reduction rates of Clinical Globle Impression Scale and Hamilton Depression Rating Scale as indicators of efficacy evaluation, the patients were divided into an effective group （21 cases） and an ineffective group （11 cases）. All patients were performed ~99mTc-ECD brain perfusion imaging （1 110 MBq by intravenous injection） before and after treatment, respectively. Results In the patients with depression, reduced cerebral blood flow mainly located in the prefrontal lobe and cingulate gyrus. After treatment, with improvement in depression, cerebral blood flow improved significantly. Assessed by brain perfusion SPECT in the efficacy of antidepressant treatment, the lower left anterior frontal perfusion was, the better the antidepressant effect was obtained. Conclusion SPECT imaging is valuable in efficacy estimation of antidepressant treatment.

关 键 词：多巴胺转运体 抑郁症 SPECT显像技术 氟西汀 

分 类 号：R749.4[医药卫生—神经病学与精神病学]