功能性消化不良伴抑郁、焦虑状态患者脑功能检查的临床分析  

Brain function in patients with functional dyspepsia associated with depression and anxiety state

作　　者：刘钰[1] 汪良芝[2] 

机构地区：[1]解放军第102医院消化内科,江苏常州213003 [2]苏州大学附属第三医院干部一科,江苏常州213003

出　　处：《临床荟萃》2017年第9期770-773,共4页Clinical Focus

基　　金：常州市卫生人才培养工程资助(2016CZBJ019)

摘　　要：目的研究功能性消化不良(FD)与精神心理因素的关系,探讨脑功能检查诊断FD伴抑郁焦虑状态患者的临床意义。方法选取诊断为FD的100例患者及30例健康志愿者,进行宗氏焦虑自评量表(SAS)、宗氏抑郁自评量表(SDS)心理评估。分别行脑电图及脑电超慢涨落技术(ET)检查,比较FD组与对照组脑电图异常率及脑神经递质的差异。结果 FD组焦虑发生率为30%,抑郁发生率为33%,焦虑合并抑郁发生率为11%,对照组焦虑发生率为6.7%,抑郁发生率为10%,FD组SDS评分、SAS评分明显高于对照组(P<0.05)。FD患者组脑电图异常率35%,较对照组明显增高(P<0.05)。焦虑状态FD患者脑神经递质γ-氨基丁酸(GABA)明显低于对照组,去甲肾上腺素(NE)、乙酰胆碱(Ach)、谷氨酸(Glu)高于对照组(P<0.05)。抑郁状态FD患者脑神经递质5-羟色胺(5-HT)、多巴胺(DA)明显低于对照组(P<0.05)。焦虑合并抑郁状态FD患者5-HT、DA低于对照组,NE高于对照组(P<0.05)。单纯FD患者脑神经递质活动与对照组比较差异无统计学意义(P>0.05)。结论 FD患者抑郁焦虑状态发生率、脑电图异常率高于普通人群,可能与脑内神经递质变化,脑功能紊乱有关。Objective To investigate the relationship between functional dyspepsia（FD）and mental psychological factors and explore the clinical significance of brain function check diagnosis on FD patients associated with anxiety and depression state.Methods Psychological assessments,Self-Rating Anxiety Scale（SAS）and SelfRating Depression Scale（SDS）were performed on 100 FD patients and 30 healthy volunteers.Electroencephalogram（EEG）and encephalofluctuo gram technology（ET）were also performed to compare the abnormal rates and the differences of neurotransmitter between FD and control group.Results Of 100 FD patients,the incidence rates of anxiety,depression and both anxiety and depression states were 30%,33% and 11%,respectively.Of 30 healthy volunteers,the incidence rates of anxiety and depression were 6.7% and 10%,respectively.The scores of SDS and SAS in FD group were obviously higher than those of control group（P〈0.05）.EEG abnormal rate in FD patient group was significantly higher than that of control group,respectively 35% and 10%（P〈0.05）.Neurotransmittersγ-aminobutyric acid（GABA）activity was decreased much more in FD with anxiety state than that of control group,while norepinephrine（NE）,acetylcholine（Ach）and glutamic acid（Glu）activities were significantly higher than those of control group（P〈0.05）.Neurotransmitters 5-hydroxytryptamine（5-HT）and dopamine（DA）were much lower in FD patients with depression state than those of the control group（P〈0.05）.5-HT and DA were lower in FD with anxiety and depression state than those of control group,but NE was significantly higher than that of control group（P〈0.05）.There was no statistical significance in the difference of neurotransmitter activity between FD patients without anxiety and depression state and control group（P〉0.05）.Conclusion The incidence rate of anxiety and depression state and the abnormity of EEG in FD patients are much higher than common people,the reason is due to the inordinate chang

关 键 词：消化不良 抑郁 焦虑 神经递质 

分 类 号：R57[医药卫生—消化系统]