PTSD患者海马体积及代谢物水平的研究  

Changes of hippocampal volume and metabolites levels in patients with posttraumatic stress disorder

作　　者：朱丞[1] 孙晓海[2] 赵虎[3] 谢宝军[4] 刘忠纯[5] 王晓萍[5] 

机构地区：[1]汕头大学医学院法医学系,515031 [2]深圳市宝安区石岩人民医院妇产科 [3]中山大学中山医学院法医学系 [4]武汉大学人民医院放射科 [5]武汉大学人民医院精神卫生中心

出　　处：《浙江医学》2012年第3期162-165,172,共5页Zhejiang Medical Journal

摘　　要：目的 观察创伤后应激障碍（PTSD）患者海马体积及代谢物水平的变化,探讨PTSD 严重程度、海马体积及海马代谢物水平之间的关系.方法 采用磁共振成像（MRI）和频谱（MRS）技术对14 例PTSD患者及14 例对照者进行海马在体研究,计算两组间的海马体积及代谢物水平并进行组间比较.采用事件影响量表-修订版评估PTSD 的严重程度.结果 PTSD 病例组的左侧海马体积明显小于对照组（ ＜0.05）,减少8.0%.PTSD 病例组的左、右两侧海马NAA/Cr比值,均明显低于对照组（ ＜0.01 和0.05）;与对照组相比,PTSD 病例组的左侧海马NAA/Cr 比值下降15%,右侧海马下降5.9%.事件影响量表- 修订版（IES-R）总分,与左侧海马体积和NAA/Cr比值呈显著负相关.回归方程为：ISE-R 总分=128.9-39.47 左侧海马NAA/Cr-0.092 左侧海马体积.结论 PTSD 患者可出现海马损害.两侧海马对创伤性事件的损害作用具有不同的易感性.对右利手受试来说,左侧海马对个体后期的创伤性经历的易感性可能更高.Objective To investigate the volume and metabolic abnormality of hippocampus in patients with posttraumatic stress disorder （PTSD）, and their association with PTSD severity. Methods Magnetic resonance imaging （MRI） and proton magnetic resonance spectroscopy （1H-MRS） were performed in 14 patients with PTSD and 14 healthy subjects. Hippocampal volume and the ratios of N-acetylaspartate/creatinine （NAA/Cr） and Choline/creatinine （Cho/Cr） were calculated and compared to control. The severity of PTSD in the patients was evaluated by the Impact of Event Scale-Revised （ IES-R）scale. Results There was significant deficit of left hippocampal volumes in the PTSD patients （8.0%）, compared to the healthy subjects. Significant reduction of NAA/Cr ratio in both left （15%） and right （5.9%） hippocampus were observed in the PTSD group compared to controls. The severity of PTSD was associated with decreased left hippocampal volume and NAA/Cr ratio. The regression equation was： total score of ISE-R = 128.9 - 39.47 x NAA/Cr of left hippocampus - 0.092 x left hippocampal volume. Conclusion Volume loss and NAA/Cr ratio reduction imply that there are hippocampal abnormalities in PTSD. Furthermore, bilateral hippocampus shows different vulnerability to traumatic events; for the right handed subjects, hippocampal dysfunction is lateralized with the left side being more vulnerability than the right.

关 键 词：创伤后应激障碍 海马 磁共振成像 质子磁共振频谱 

分 类 号：R742.1[医药卫生—神经病学与精神病学]