焦虑症患者应激时情绪反应及脑功能状况  

Functional Brain Image and Emotional Response of Patients with Anxiety Disorder in Experimental Stress

作　　者：万黎[1] 吴文源[2] 李春波[2] 刘健 王冰[3] 李玉珊[2] 

机构地区：[1]上海市东方医院心理咨询门诊,200120 [2]上海市同济大学附属同济医院心身科,200065 [3]同济医院核医学科

出　　处：《中国心理卫生杂志》2002年第6期373-376,共4页Chinese Mental Health Journal

基　　金：铁道部科技专项经费资助项目 (编号J98Z1 0 )

摘　　要：目的 :研究焦虑症患者应激状态下的情绪变化特点及其脑功能活动状况。方法 :对 2 0例未经治疗的焦虑症患者和 2 0例健康人采用瑞文测试进行模拟应激 ,以焦虑状态 /特质询问表 (STAI)和心率、肌电等指标评估受试者应激前后的情绪水平 ,采用单光子发射型计算机断层显像技术对两组进行双日法平静及紧张状态局部脑血流灌注 (rCBF)检查。结果 :(1)经配对t检验 ,应激后两组受试者STAI分、心率、肌电均显著高于应激前 (P <0 0 1)。 (2 )经配对t检验 ,病例组模拟应激前后STAI分、心率、肌电显著高于对照组 (P <0 0 5及 0 0 1) ;经协方差分析 ,病例组应激前后STAI的变化显著大于对照组。 (3 )经协方差分析 ,患者部分脑区应激前后rCBF变化与对照组有显著差异 (P <0 0 5及 0 0 1) ,且应激后rCBF呈下降趋势。结论 :模拟应激过程能有效诱发受试者的焦虑反应。焦虑症患者可能存在大脑皮层情绪控制功能的减弱 ,使其应激过程中的情绪波动明显高于正常人 。Objective: to study emotional response of patients with anxiety disorder in experimental stress through functional brain image Method: 20 anxiety patients without experience of psychiatric treatment were enrolled with 20 healthy volunteers as control The baseline and simulating stress 99 mTc-EDC SPECT (rCBF) were performed within two days Intelligence test was used as stressor When taking SPECT, State-Trait Anxiety Scale (STAI) was used to evaluate the emotional response of subjects, heart rate (HR) and muscle electricity gram (ME) were also recorded Result: 1) The score of STAI, HR and ME increased after simulating stress in all subjects 2) Patients group had higher scores than control 3) The change of rCBF in stress of patient group was different from that of control significantly, patients had an decreased rCBF after simulating stress Conclusion: Simulating stress can invoke anxiety response of patients, who have stronger emotional response and less rCBF than healthy control, indicating dysfunction in regulation of emotion

关 键 词：情绪反应 脑功能 焦虑症 应激反应 焦虑反应 局部脑血流灌注 

分 类 号：R749.72[医药卫生—神经病学与精神病学]