伴自杀意念青年双相障碍Ⅱ型患者脑血流灌注特征及临床意义  

Cerebral blood flow perfusion characteristics and clinical significance in young bioplar disorder typeⅡpatients with suicidal ideation

作　　者：徐顺徭 夏王斌 金辉 XU Shunyao;XIA Wangbin;JIN Hui(Department of Psychiatry,Wenzhou Seventh People's Hospital,Wenzhou 325000,China)

机构地区：[1]温州市第七人民医院精神科,325000

出　　处：《心电与循环》2024年第4期338-342,I0003,共6页Journal of Electrocardiology and Circulation

摘　　要：目的 探讨伴自杀意念青年双相障碍(BD)Ⅱ型患者脑血流灌注特征及临床意义。方法 回顾性选取2020年2月至2021年4月温州市第七人民医院精神科收治的84例伴自杀意念青年BDⅡ型患者为研究对象,年龄17~40岁。根据自杀意念自评量表(SIOSS)绝望、乐观和睡眠等3个因子总分结果分为有自杀意念(≥12分)组40例、无自杀意念(<12分)组44例;另选取同期本院健康体检者40名为对照组。采用MRI检测静息时脑血流量(CBF),比较3组研究对象蒙特利尔认知评估量表(Mo CA)、汉密尔顿焦虑量表(HAMA)、24项汉密尔顿抑郁量表(HAMD_(24))、SIOSS评分以及局部CBF,分析脑血流灌注差异脑区CBF与各量表评分的相关性。结果 有自杀意念组、无自杀意念组Mo CA总分均明显低于对照组(均P<0.05),且有自杀意念组低于无自杀意念组(P<0.05)。有自杀意念组、无自杀意念组HAMA、HAMD_(24)和SIOSS评分均明显高于对照组(均P<0.05),且有自杀意念组均高于无自杀意念组(均P<0.05)。有自杀意念组左侧壳核、左侧前扣带皮质和左侧颞上回区域CBF均明显高于无自杀意念组、对照组(均P<0.05),右侧后扣带回、右颞下回区域CBF均低于无自杀意念组(均P<0.05)。左侧壳核、左侧颞上回和右颞下回CBF与Mo CA、HAMA、HAMD_(24)、SIOSS评分均呈正相关(均P<0.05);左侧前扣带皮质、右侧后扣带回CBF与Mo CA、HAMA、HAMD_(24)、SIOSS评分均呈负相关(均P<0.05)。结论 伴自杀意念青年BDⅡ型患者脑部左侧壳核、左侧前扣带皮质和左侧颞上回区域CBF升高,而右侧后扣带回、右颞下回区域CBF明显降低,且与认知功能、焦虑症状、抑郁症状以及自杀意念相关。Objective To explore the characteristics of cerebral blood flow perfusion and their clinical significance in young bipolar disorder(BD) type Ⅱ patients with suicidal ideation. Methods A retrospective study was conducted included 84 first-time BD type Ⅱ patients, aged 17-40 years who were admitted to the Department of Psychiatry at Wenzhou Seventh People's Hospital from February 2020 to April 2021. According to the total score of the three factors(despair, optimism, and sleep) of the self-rating scale for suicide intention(SIOSS), they were divided into a suicidal ideation group(≥12 points) with 40 cases and a non-suicidal ideation group(<12 points) with 44 cases. Another 40healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group. MRI was used to detect resting cerebral blood flow(CBF), and the Montreal cognitive assessment scale(Mo CA), Hamilton anxiety scale(HAMA), 24-item Hamilton depression scale(HAMD_(24)), SIOSS scores, and local CBF were compared among three groups of study subjects. The correlation between CBF in different brain regions and scores on each scale was analyzed. Results The total Mo CA scores of the group with suicidal ideation and the group without suicidal ideation were significantly lower than those of the control group(both P<0.05), and the group with suicidal ideation was lower than the group without suicidal ideation(P<0.05). HAMA in the group with suicidal ideation,HAMA in the group without suicidal ideation The HAMD_(24)and SIOSS scores were significantly higher than the control group(all P<0.05), and the group with suicidal ideation was higher than the group without suicidal ideation(all P<0.05).The CBF in the left putamen, left anterior cingulate cortex, and left superior temporal gyrus of the group with suicidal ideation was significantly higher than that of the group without suicidal ideation and the control group(all P<0.05), while the CBF in the right posterior cingulate gyrus and right inferior tempor

关 键 词：双相障碍Ⅱ型 脑血流灌注 认知功能 自杀意念 焦虑 抑郁 

分 类 号：R749.4[医药卫生—神经病学与精神病学]