^1H-MRS检测儿童及青少年创伤后应激障碍大脑前扣带回代谢物改变  

1H-MRS in detection of metabolites changes in anterior cingulate cortex of pediatric and adolescent patients with post traumatic stress disorder

作　　者：钟洋[1] 全红[1] 杨志勇[1] 

机构地区：[1]武汉大学物理科学与技术学院医学物理实验室,湖北武汉430072

出　　处：《中国医学影像技术》2014年第9期1335-1338,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(10875092);湖北省自然科学基金(2012FKB04449)

摘　　要：目的探讨儿童及青少年创伤后应激障碍(PTSD)患者1 H-MRS中大脑前扣带回区代谢物水平的变化。方法纳入汶川地震幸存者57人,包括10例PTSD患者、23名PTSD康复者和24名健康者。对所有研究对象行1 H-MRS检查,检测大脑前扣带回区N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、肌醇(MI)和谷氨酸和谷氨酰胺复合物(Glx)水平,计算并比较NAA/Cr、Glx/Cr、Cho/Cr、MI/Cr的差异。结果 Glx/Cr:PTSD患者(1.16±0.15)、PTSD患者+PTSD康复者(1.31±0.07)均明显低于健康者(1.59±0.10),PTSD患者明显低于PTSD康复者+健康者(1.48±0.07),差异均有统计学意义(P均<0.05),PTSD康复者(1.37±0.08)与健康者和PTSD患者间差异均无统计学意义(P均>0.05)。NAA/Cr、Cho/Cr和MI/Cr差异均无统计学意义(P均>0.05)。结论 1 H-MRS中儿童及青少年PTSD患者大脑前扣带回区Glx明显下降,其改变可能在PTSD病理生理机制中发挥重要作用。Objective To investigate the changes of metabolites level in anterior cingulate cortex of pediatric and adoles-cent patients with post traumatic stress disorder （PTSD） using 1 H-MRS. Methods Totally 57 earthquake survivors inclu-ding 10 PTSD patients, 23 rehabilitative subjects and 24 healthy subjects were enrolled. 1 H-MRS of anterior cingulate cor-tex was performed in all the subjects. The level of N-acetylaspartate （NAA）, Creatine （Cr）, Choline （Cho）, Glutamate-Glutamine （Glx） and Myo-Inositol （MI） was detected, and the NAA/Cr, Glx/Cr, Cho/Cr, MI/Cr was calculated andcompared between different subjects. Results Glx/Cr in PTSD patients （1.16± 0.15） and PTSD patients＋ rehabilitativesubjects （1.31± 0.07） were both significantly lower than those in healthy subjects （1.59±0. 10, both P〈0.05）. Glx/Crin PTSD patients was significantly lower than that in rehabilitative subjects＋ healthy subjects （1.48-l-0. 07, P〈0.05）.There were no differences of Glx/Cr between rehabilitative subjects （1.37± 0.08） and healthy subjects as well as PTSD pa-tients （both P〈0.05）. No differences were found between the three kinds of subjects for NAA/Cr, Cho/Cr and MI/Cr（all P〈0.05）. Conclusion In 1 H-MRS, the level of Glx in anterior cingulate cortex reduces significantly in pediatric andadolescent PTSD patients, which may play an important role in pathogenesis of PTSD.

关 键 词：应激障碍 创伤后 磁共振波谱学 前扣带回 

分 类 号：R445.2[医药卫生—影像医学与核医学]