慢性精神分裂症患者手术治疗前后双侧海马磁共振波谱成像研究  

Study of Bilateral Hippocampal Magnetic Resonance Spectroscopy Imaging in Patients with Chronic Schizophrenia before and after Surgery

作　　者：郑润君 陈埼 黄少雅 ZHENG Runjun;CHEN Qi;HUANG Shaoya(Fuzhou Neuropsychiatric Prevention and Treatment Hospital,Fujian Province,Fuzhou 350008,China;不详)

机构地区：[1]福建省福州神经精神病防治院,福建福州350008

出　　处：《中外医学研究》2021年第34期74-78,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福州市科技计划项目(2019—SZ—62)。

摘　　要：目的:利用磁共振波谱(MRS)对慢性精神分裂症患者手术治疗前后海马代谢产物进行研究,并进一步评估,从而分析MRS对精神分裂症患者的临床价值。方法:随机选取福建省福州神经精神病防治院2019年11月-2020年8月收治的50例慢性精神分裂症患者作为观察组,同时选取50例健康志愿者作为对照组。采用MATRICS认知评估量表(MCCB)评估观察组和对照组的认知得分;其中观察组患者进行6个月立体定向治疗,再进行MRS检查,对照组及观察组治疗前后海马区域的代谢产物包括N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr)、胆碱化合物(Cho)和肌醇(MI),并以Cr为参照物,分别计算NAA/Cr、Cho/Cr和MI/Cr的值。结果:(1)观察组的各项MCCB得分明显低于对照组,差异有统计学意义(P<0.05)。(2)观察组双侧海马的NAA/Cr比值均低于对照组(P<0.05),观察组双侧海马的MI/Cr、Cho/Cr比值均高于对照组(P<0.05)。(3)观察组患者行6个月立体定向放射治疗后,其双侧海马的NAA/Cr、MI/Cr和Cho/Cr比值与治疗前比较,差异无统计学意义(P>0.05)。结论:精神分裂症患者的海马可能存在神经元的损害和细胞膜磷脂代谢异常,MRS能有效检测出慢性精神分裂症患者海马代谢指标的异常,立体定向治疗对精神分裂症患者海马区域的细胞膜代谢无显著影响,MRS为该病的临床诊断提供了依据。Objective:To study the use of magnetic resonance spectroscopy (MRS) of the hippocampal metabolites before and after surgery in patients with chronic schizophrenia,and further evaluation,so as to analyze the clinical value of MRS in patients with schizophrenia.Method:Fifty patients with chronic schizophrenia from November 2019 to August 2020 in Fuzhou Neuropsychiatric Prevention and Treatment Hospital,Fujian province were randomly selected as the observation group,and 50 healthy volunteers were selected as the control group.The cognitive scores of the observation group and the control group were evaluated by the MATRICS cognitive assessment scale (MCCB);the observation group received stereotactic therapy for 6 months,and then MRS was performed to examine the metabolism of the hippocampus before and after treatment in the control group and the observation group,the products included N-acetyl aspartic acid (NAA),creatine complex (Cr),choline compound (Cho) and inositol (MI),and with Cr as the reference substance,calculated the value of NAA/Cr,Cho/Cr and MI/Cr.Result:(1) The MCCB scores of the observation group were significantly lower than those of the control group,and the differences were statistically significant (P<0.05).(2) The NAA/Cr ratios of the bilateral hippocampus of the observation group were lower than those of the control group (P<0.05),and the MI/Cr and Cho/Cr ratios of the bilateral hippocampus of the observation group were higher than those of the control group (P<0.05).(3) The NAA/Cr,MI/Cr and Cho/Cr ratios of the bilateral hippocampus of patients in the observation group were not significantly different before and after stereotactic radiotherapy for 6 months,and there were no statistical significant differences (P>0.05).Conclusion:The hippocampus of patients with schizophrenia may have neuronal damage and abnormal cell membrane phospholipid metabolism.MRS can effectively detect the abnormality of hippocampal metabolism indicators in patients with chronic schizophrenia.Stereotactic therapy has no s

关 键 词：精神分裂症 磁共振波谱 海马 N-乙酰基天门冬氨酸 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.3[医药卫生—诊断学]