抑郁强迫症及单纯强迫症患者暂时记忆系统及脑生化代谢物水平的差异研究  

Comparison of temporary memory system and brain biochemical metabolites in patients with depressive obsessive-compulsive disorder and simple obsessive-compulsive disorder

作　　者：陈浩然 林崇光 程郎朗 许毅[2] Chen Haoran;Lin Chongguang;Cheng Langlang;Xu Yi(Wenzhou Seventh People's Hospital,Psychosomatic Medicine,Wenzhou 325000,China;Department of Mental Health,First Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 310003,China)

机构地区：[1]浙江省温州市第七人民医院心身医学科,325000 [2]浙江大学医学院附属第一医院精神卫生科,杭州310003

出　　处：《中国医师杂志》2020年第1期50-53,58,共5页Journal of Chinese Physician

摘　　要：目的比较抑郁强迫症及单纯强迫症患者暂时记忆系统及脑生化代谢物水平的差异。方法选取2017年6月至2018年6月于温州市第七人民医院首次就诊的单纯强迫症患者31例、抑郁强迫症患者33例及健康体检志愿者25例为研究对象,通过n-Back、Stoop色彩关联测试及数字广度测试检测三组的暂时记忆能力;采用氢质子磁共振波普(1H-MRS)检测三组双侧前额叶白质、前扣带回皮质N-乙酰天冬氨酸(NAA)、胆碱复合物(Cho)及肌酸(Cr)3种脑生化代谢物,以Cr为参照物,计算NAA/Cr及Cho/Cr比值。结果单纯强迫症及抑郁强迫症组患者耶鲁-布朗强迫症状量表(Y-BOCS)及24项汉密尔顿抑郁量表评分(HAMD24)显著高于健康对照组,且抑郁强迫症组HAMD24评分明显高于单纯强迫症组,差异均有统计学意义(P<0.05)。单纯强迫症组和抑郁强迫症组患者n-Back正确数均明显低于健康对照组,差异均有统计学意义(P<0.05)。单纯强迫症组和抑郁强迫症组患者DST评分为(14.37±2.96)分、(12.39±2.14)分,显著低于健康对照组(17.46±3.28),差异有统计学意义(P<0.05)。三组间双侧前扣带回皮质NAA/Cr及Cho/Cr值差异均无统计学意义(P>0.05)。与健康对照组比较,单纯强迫症组及抑郁强迫症组患者双侧前额叶白质NAA/Cr值均显著降低,且抑郁强迫症组低于单纯强迫症组,差异均有统计学意义(P<0.05)。结论单纯强迫症及抑郁强迫症患者均存在言语记忆损伤及双侧前额叶白质神经功能下降;抑郁强迫症患者还存在中央执行记忆损伤。Objective To investigate the difference of temporary memory system and brain biochemical metabolites between patients with depressive obsessive-compulsive disorder and simple obsessive-compulsive disorder.Methods From June 2017 to June 2018,31 patients with simple obsessive-compulsive disorder,33 patients with depressive obsessive-compulsive disorder and 25 healthy volunteers were selected as subjects.The temporary memory ability of the three groups was tested by n-back,Stoop color association test and digital breadth test.Three brain sublimation metabolites,N-acetylaspartate acid(NAA),choline complex(Cho)and creatine(Cr),were detected by proton magnetic resonance pop(1H-MRS)in bilateral prefrontal white matter,anterior cingulate cortex and anterior cingulate cortex.The ratio of NAA/Cr and Cho/Cr was calculated with Cr as reference material.Results The scores of Yale-brown obsessive-compulsive severity scale(Y-BOCS)and Hamilton depression rating scale 24(HAMD24)in the patients with simple obsessive-compulsive disorder and depression obsessive-compulsive disorder group were significantly higher than those in the healthy control group,and the scores of HAMD24 in the patients with depression obsessive-compulsive disorder group were significantly higher than those in the patients with simple obsessive-compulsive disorder group,with statistically significant difference(P<0.05).The number of correct n-back in the simple obsessive-compulsive group and the depressive obsessive-compulsive group was significantly lower than that in the healthy control group(P<0.05).The digital span test(DST)scores of the patients in the simple obsessive-compulsive disorder group and the depressive obsessive-compulsive disorder group were(14.37±2.96)and(12.39±2.14),which were significantly lower than those in the healthy control group(17.46±3.28)(P<0.05).There was no significant difference in NAA/Cr and Cho/Cr between the three groups(P>0.05).Compared with the healthy control group,the NAA/Cr value of bilateral prefrontal white matter in

关 键 词：强迫性障碍 抑郁症 记忆 短时 N-乙酰天冬氨酸 胆碱复合物 肌酸 

分 类 号：R749.7[医药卫生—神经病学与精神病学]