首发未经治疗的抑郁症患者前额叶、海马质子波谱特征及其与皮质醇水平的相关性  

The correlation between the plasma cortisol level and the characteristics of magnetic resonance spectroscopy of the prefrontal cortex and hippocampus in first-episodeanddrug-naive major depressive disorder patients

作　　者：李瑽睿 郑周丽 邓慧怡 吴赤蓬[2] 史长征[3] 徐浩[4] 徐伊[1] LI Congrui;ZHENG Zhouli;DENG Huiyi;WU Chipeng;SHI Changzheng;XU Hao;XU Yi(Department of Psychiatry,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China;Department of Public Health and Preventive Medicine,Jinan Univesity Medical College,Cuangzhou 516032,China;Medical Imaging Center,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China;Department of Nuclear Medicine,the First Affiliated Hospital of Jinan University,Guangzhou 516032,China)

机构地区：[1]暨南大学附属第一医院精神医学科,广东广州516032 [2]暨南大学医学院公共卫生与预防医学系,广东广州516032 [3]暨南大学附属第一医院医学影像中心,广东广州516032 [4]暨南大学附属第一医院核医学科,广东广州516032

出　　处：《暨南大学学报（自然科学与医学版）》2021年第5期451-455,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广东省自然科学基金项目(2017A030313648);广州市科技计划项目(2014J4100017)。

摘　　要：目的:使用二维多体素质子磁共振波谱(2D1H-MRS)评估未经治疗的抑郁症(MDD)患者血浆皮质醇水平与前额叶、海马的神经化学指标之间的关系.方法:招募33例未经药物治疗的MDD患者和20名健康受试者,接受前额叶和海马的1H-MRS检查和晨血浆皮质醇测量,比较两组皮质醇水平和1H-MRS各项指标值变化并分析其相关性.结果:MDD患者的皮质醇水平高于正常对照组(P=0.000),且与其左前额叶的N-乙酰天门冬氨酸(NAA)值成负相关关系(r=-0.625,P=0.041),与左海马NAA值成正相关关系(r=0.647,P=0.043).MDD患者左前额叶NAA值低于正常对照组(P=0.006),左右海马NAA、胆碱(Cho)、肌酸(Cr)值均低于对照组(P<0.05).结论:抑郁症患者前额叶、海马的能量代谢异常先于其结构的异常,且与血浆皮质醇水平的改变有一定的相关关系.Objective:To investigate the relationship between the characteristic changes of magnetic resonance spectroscopy of prefrontal cortex and hippocampus and the plasma cortisol level in first-episodeand drug-naive major depressive disorder patients.Methods:Thirty patients with MDD and twenty healthy subjects were recruited to receive 2 D1H-MRS examination and morning blood samples for cortisol measurement.The levels of NAA,Cho,Cr in prefrontal cortex and hippocampus and serum cortisol levels between MDD patients and healthy subjects were compared and evaluated the linear correlation were evaluated.Results:The level of plasma cortisol in depression groupwas higher than that in normal control group(P=0.000);The level of NAA in the left Prefrontal cortex of depression group was lower than that of normal control(P=0.006);and the levels of NAA,Cho,Cr in both left and right hippocampus of depression group was lower than those of normal control group(P<0.05);In the depression group,a negative correlation between the level of plasma cortisol and the level of NAA in the left prefrontal cortex was observed(r=-0.625,P=0.041),while in the left hippocampus,the correlation between them was positive(r=0.647,P=0.043).Conclusion:The changes of energy metabolism may happen before the structural damage of prefrontal cortex and hippocampus,and correlate to the changes of the level of plasma cortisol in depression patients.

关 键 词：抑郁症 皮质醇 磁共振波谱 前额叶 海马 

分 类 号：R749.4[医药卫生—神经病学与精神病学]