青少年抑郁症患者情感症状转归与认知功能及脑氧合血红蛋白水平的相关性分析  

The relationship between clinical outcome of emotional symptoms and cognitive function and cerebral oxygenated hemoglobin in adolescents with depression

作　　者：乔丹 梁秀梅 温宇娇 徐一凡 李琪琪 李改智 杨春霞[1] 刘志芬[1] Qiao Dan;Liang Xiumei;Wen Yujiao;Xu Yifan;Li Qiqi;Li Gaizhi;Yang Chunxia;Liu Zhifen(Department of Psychiatry,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院精神卫生科,太原030001

出　　处：《中华精神科杂志》2024年第1期25-32,共8页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(82171534);中央引导地方科技发展资金(YDZJSX2022A063);山西省科技创新人才团队(202204051001027);山西省136兴医工程(Y2022136014)。

摘　　要：目的探讨青少年抑郁症患者情感症状转归与认知功能及脑氧合血红蛋白水平的关系。方法前瞻性收集2020年12月至2021年12月就诊于山西医科大学第一医院的46例青少年抑郁症患者(患者组)的病例资料,其中男8例,女38例,年龄12~18(15.7±2.3)岁。所有患者接受为期8周的舍曲林治疗,根据情感症状转归情况将患者组进一步分为应答组(n=24)与无应答组(n=22)。同期招募社区的51名青少年健康志愿者作为对照组,其中男7名,女44名,年龄12~18(16.1±1.5)岁。利用可重复性神经心理状态评估(the Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)测定不同维度的认知功能,基于言语流畅任务下的功能性近红外光谱成像技术检测认知活动相关的额颞区氧合血红蛋白(oxyhemoglobin,HBO)浓度水平。比较各患者亚组与对照组、应答组与无应答组的认知功能及HBO水平差异,分析各患者组干预前后的认知功能及HBO水平变化。结果基线时,相比对照组,患者组的RBANS测验总分、即刻记忆、言语功能、注意力、延时记忆维度分数明显降低[M(Q1,Q3)][分别为88.0(82.8,100.0)分比100.0(90.0,110.0)分、78.0(73.0,87.8)分比85.0(78.0,94.0)分、(84.4±16.1)分比(95.7±15.7)分、106.0(99.5,115.0)分比118.0(109.0,128.0)分、94.0(84.5,99.0)分比97.0(91.0,101.0)分](均P<0.05),7个通道HBO水平也明显降低(均P<0.05);应答组的视觉广度和注意力维度分数高于无应答组[分别为(103.9±11.0)分比(94.4±16.7)分和(112.5±12.1)分比(98.0±21.2)分](t=2.30、2.87;均P<0.05)。干预8周后,应答组的RBANS测验总分和即刻记忆维度分数较基线水平显著升高(分别为98.8±11.2比93.0±9.7分和95.2±13.8比83.0±14.6分)(t=-3.00、-4.97;均P<0.05),注意力维度分数及前额叶皮质2个通道HBO水平仍明显低于对照组(Z=2.27、3.02、3.04;均P<0.05),无应答组即刻记忆维度分数及颞叶区域3个通道HBO水平与对照组相比差异无统Objective To explore the relationship between the clinical outcome of emotional symptoms and cognitive performance and related cerebral oxygenated hemoglobin in adolescents with depression.Methods Through subject recruitment,46 adolescent patients with depression(patient group)from the First Hospital of Shanxi Medical University were selected as the subjects for this study from December 2020 to December 2021,including 8 males and 38 females,aged 12-18(15.7±2.3)years old.All patients received sertraline treatment for 8 weeks and were further followed into responders(n=24)and non-responders(n=22)according to the outcome of emotional symptoms.In the meantime,51 healthy controls(control group)were enrolled,including 7 males and 44 females,aged 12-18(16.1±1.5)years old.The repeatable battery for the assessment of neuropsychological status(RBANS)was conducted to measure the multi-dimensional neurocognitive performance,and the functional near-infrared spectroscopy(fNIRS)was used to assess changes in the concentration of oxyhemoglobin(HBO)during the verbal fluency test.The differences were compared in multi-dimensional cognitive performance and cerebral HBO level between each patient group and control group and between responders and non-responders.The changes were analyzed in cognitive performance and cerebral HBO level after intervention in responders and non-responders.Results At baseline,compared to the control group,the patient group performed decreased scores of RBANS,immediate memory,speech function,attention,and delayed memory(88.0(82.8,100.0)M(Q1,Q3)vs.100.0(90.0,110.0)scores;78.0(73.0,87.8)vs.85.0(78.0,94.0)scores;(84.4±16.1)vs.(95.7±15.7)scores;106.0(99.5,115.0)vs.118.0(109.0,128.0)scores;94.0(84.5,99.0)vs.97.0(91.0,101.0)scores),and lower HBO levels in 7 channels(all P<0.05).Compared to responders,non-responders showed more severe impairment of visual-spatial and attention performance(103.9±11.0 vs.94.4±16.7 scores;112.5±12.1 vs.98.0±21.2 scores)(t=2.30 or 2.87;all P<0.05).After treatment,the scores o

关 键 词：抑郁症 青少年 症状转归 认知功能 功能性近红外光谱成像 

分 类 号：R749.4[医药卫生—神经病学与精神病学]