首发偏执型精神分裂症患者脑垂体体积的研究  

Study of pituitary volume in first-episode and paranoid schizophrenia

作　　者：陈金卫 冀宾[2] 梅维[3] 伍秋林[4] 张汉锡 林文霞[1,2] 肖壮伟[1,4] 

机构地区：[1]汕头大学医学院,广东汕头515041 [2]广东省汕头市第二人民医院,广东汕头515041 [3]汕头大学医学院第一附属医院,广东汕头515041 [4]广东省医学分子影像重点实验室,广东汕头515041

出　　处：《现代中西医结合杂志》2015年第24期2626-2629,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金面上项目(30670598)

摘　　要：目的探讨首发未用药偏执型精神分裂症患者脑垂体体积的改变。方法选择25例首发偏执型精神分裂症患者作为患者组,25例年龄、性别、受教育年限等与患者组相匹配的健康对照者作为对照组。应用1.5T磁共振成像仪对所有受试者进行头颅结构磁共振扫描获得3D脑结构图像,采用MRIcro和MATLAB软件分别进行垂体体积和大脑体积测量。以阳性和阴性症状量表(PANSS)评估患者精神症状。分析患者的垂体体积与年龄、教育年限、发病年龄、病程、PANSS总分和各项因子分的相关性。结果患者组垂体体积大于对照组(P<0.05);对照组女性的垂体体积大于男性。偏相关分析显示,垂体体积与PANSS总分存在正相关关系(r=0.454,P=0.029),其余指标与垂体体积均无明显相关性(P均>0.05)。结论首发未用药偏执型精神分裂症患者垂体体积有异常增大的改变,并与临床症状严重程度有关联,提示患者在发病早期阶段下丘脑-垂体-肾上腺轴腺体存在应激反应的易感性,这些异常改变可能与精神分裂症的神经内分泌机制有关。垂体体积可能存在性别效应。Objective It is to approach the changes of pituitary volume in first-episode and paranoid schizophrenia patients （FEPS） not treated with antipsychotie drugs. Methods A sample of 25 FEPS and 25 cases with age-years of received educa- tion and sex-matched healthy controls were scanned by 1.5T Three-dimensional Magnetic Resonance Imaging. The pituitary volume and intracranial volume were measured respectively by applying MRIcro and MATLAB software. Symptoms were as- sessed using the Positive and Negative Syndrome Scale （PANSS）. The differences between two groups were compared and the correlation of pituitary volume with age, age of education, age of onset, duration of disease, and score of PANSS was also ana- lyzed. Results Compared with healthy controls, FEPS showed a larger pituitary volume （ P 〈 0.05 ）, and the pituitary tumor volume of the female was significantly higher than that of the male in control group. Partial correlation analysis showed, pitui- tary volume was significantly correlated with PANSS scores （ r = 0. 454, P = 0. 029 ） ,and no association with other clinical var- iables （P 〉 0.05）. Conclusion The pituitary volume in FEPS not treated with antipsychotic drugs has change of abnormal in- crease, and it related to the clinical symptom severity. It suggesting that the gland of hypothalamus pituitary adrenal axis in pa- tients has stress response susceptibility in the early stage, these abnormal changes may be related to the mechanism of the spir- it of schizophrenia. Pituitary volume may have sex effect.

关 键 词：首发精神分裂症 HPA轴 垂体体积 磁共振成像 

分 类 号：R749.3[医药卫生—神经病学与精神病学]