疑病症患者脑葡萄糖代谢改变的正电子发射断层显像研究  

18SF-fluorodeoxyglucose positron emission tomography changes in brain glucose metabolism in patientswith hypochondriasis

作　　者：孙达亮[1] 邱春[2] 蔡亦蕴[1] 王志阳[1] 施慎逊[1] 管一晖[2] 华逢春[1] 

机构地区：[1]复旦大学附属华山医院精神医学科,上海200040 [2]复旦大学附属华山医院精神PET中心,上海200040

出　　处：《中华精神科杂志》2013年第2期104-108,共5页Chinese Journal of Psychiatry

摘　　要：目的探讨疑病症患者脑葡萄糖代谢的变化特点。方法对符合《中国精神障碍分类与诊断标准（第3版）》中疑病症诊断标准的11例患者（疑病症组）与年龄、性别相匹配的23名对照（对照组）进行脑氟-18脱氧葡萄糖正电子发射断层显像，将脑部图像数据与统计参数图的模板进行空间归一化后分析2组受试者脑葡萄糖代谢的差异。结果与对照组比较，疑病症组右角回及顶下小叶（Z=4．72）、右岛叶（Z=4．19）、右额中央前回（Z=4．15）和中央旁小叶（Z=3．52）、右顶叶楔前回（Z=4．09）、右额中回（Z=3．39）和额下回（Z=3．79）、左后扣带回（Z=3．95）、左顶叶楔前回（Z=3．98）、左额中央前回（Z=3．72）、双侧丘脑及中脑、豆状核葡萄糖代谢增高（Z≥3．94）；右颞上回（Z=4．05）、右额叶直回（Z=3．93）、右额上回（Z=3．14）、左额叶直回（Z=3．59）葡萄糖代谢明显减低（P均〈0．001）。结论疑病症患者存在多处脑区葡萄糖代谢异常。Objective To investigate the brain glucose metabolism in hypochondriasis with ＇~l~＇- fluorodeoxyglucose positron emission tomography （FDG-PET） compared with health subjects. Methods Eleven patients diagnosed as hypochondriasis according to CCMD-3 criteria and 23 age- and sex-matched healthy subjects were performed FDG PET/CT scan. All FDG-PET images were spatially normalized using statistical parametric mapping （SPMS; http ：//www. ill. ion. ucl. ac. uk/spm/） with an original template of SPM. Then the study analyzed the differences between the two groups to compare regarding respective FDG metabolism. Results Voxel-wise comparison of FDG-PET images was conducted using SPM8 to identify the brain regions showing glucose hypermetabolism in the right angular gyrus and inferior parietal lobule （Z = 4. 72）, right insula （ Z = 4.19 ）, right precentral gyms （ Z = 4.15 ） and paracentral lobule （ Z = 3.52 ）, fight precuneate gyms （ Z = 4.09 ）, right middle （ Z = 3.39 ） and inferior frontal gyms （ Z = 3.79 ）, left posterior cingulate （Z = 3.95 ）, left precuneate gyms （ Z = 3.98 ）, left precentral gyms （ Z = 3.72 ）, bilateral thalamus, mesencephalon and lentiform nucleus （Z~〉 3.94）. In addition, glucose hypometabolism was found in the right superior temporal gyrus （ Z = 4.05 ） , right gyrusrectus （ Z = 3.93 ） , right superior frontal gyms （Z = 3.14 ） and left gyrusrectus （Z = 3.59 ） in comparison with that of the normal subjects （P 〈 0. 001 ）. Conclusions Hypochondriasis patients could have abnormal glucose metabolism in multiple regions of brain, which may involve the regulation of the pathophysiology in the central nervous system.

关 键 词：疑病症 脑 正电子发射断层显像术 

分 类 号：R749.7[医药卫生—神经病学与精神病学]