氟西汀治疗首发抑郁症患者海马磁共振质子波谱变化的观察  

A proton magnetic resonance spectroscopy imaging in hippocampus study in patients with primary depression with Fluoxetine therapy

作　　者：郑华[1,2] 王默力[1] 段冬梅[3] 于春水[4] 图娅[5] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]北京市丰台医院 [3]解放军总医院针灸科 [4]首都医科大学宣武医院放射科 [5]北京中医药大学针灸系

出　　处：《中华保健医学杂志》2010年第5期376-379,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市自然科学基金项目(7051003)

摘　　要：目的探讨氟西汀对首发抑郁症患者治疗前后海马的磁共振质子波谱(1H-MRS)变化及治疗效果。方法对49例首次发病的抑郁症患者行氟西汀20mg/d,治疗6周,在治疗前及治疗后第7周行磁共振常规扫描及1H-MRS检查,计算NAA/Cr和Cho/Cr比值。用汉密尔顿抑郁量表(HAMD17项)和疗效指数(EI)进行临床疗效评定。选择同期健康体检者26例为对照组。结果氟西汀治疗前抑郁症组左右侧NAA/Cr比值明显低于对照组(P<0.05);治疗后抑郁症组左右侧NAA/Cr比值均较对照组高,但右侧差异显著(P<0.05),左侧差异不明显(P>0.05)。抑郁症组左右侧Cho/Cr比值治疗前后均高于对照组,右侧差异显著(P<0.05),而左侧差异不明显(P>0.05)。抑郁症组治疗后左右侧NAA/Cr比值明显高于治疗前(P<0.05);治疗后左右侧Cho/Cr比值与治疗前比较,无显著差异(P>0.05)。HAMD评定有效率为93.88%,EI评定安全有效率为89.80%。结论氟西汀是有效治疗抑郁症的药物,能改善双侧海马神经细胞代谢功能。Objective To discuss the possible alteration of proton magnetic resonance spectroscopy（1H-MRS）in hippocampus and curative effect in patients with primary depression with Fluoxetine therapy. Methods 1H-MRS were obtained in hippocampus from 26 healthy human and 49 patients with primary depression. The ratio of NAA/Cr and Cho/Cr was calculated respectively before and after Fluoxetine therapy（20mg/d）for 6 weeks. The curative effects were evaluated by Hamilton Depression Scale and Efficacy Index（EI）. Results The NAA/Cr ratio in left and right hippocampus in patients with primary depression was lower than those in health controls before Fluoxetine therapy （P0.05）. However,the NAA/Cr ratio in bilateral hippocampal of patients was higher than those in health controls after Fluoxetine therapy. There was no significant differences in left hippocampus（P0.05）and there was obviously difference in right hippocampus（P0.05）. The Cho/Cr ratio in left and right hippocampus in patients was higher than that in health controls before or after Fluoxetine therapy,but there was no significant differences in left hippocampus（P0.05）and there was obviously difference in right hippocampus（P0.05）. After treatment, the bilateral hippocampus NAA/Cr ratio was higher than that of before treatment （P0.05）. However, there were no significant differences in bilateral hippocampus Cho/Cr ratio before and after treatment. Excellence rate were respectively 93.8% by HAMD and 89.8% by EI evaluation. Conclusions Fluoxetine is effective antidepressants in treatment primary depressive patients and can improve metabolism function of neuron cell in bilateral hippocampal.

关 键 词：抑郁症 氟西汀 磁共振波谱学 海马 

分 类 号：R749[医药卫生—神经病学与精神病学]