首发抑郁障碍患者前额叶磁共振波谱特征及其诊断价值研究  

Study on the characteristics and diagnostic value of1H-MRS on the frontal lobe in patients with first-episode depressive disorder

作　　者：宋红涛 梅安昌 刘娴[1] 陶庆 李静雅 焦东亮 SONG Hongtao;MEI Anchang;LIU Xian;TAO Qing;LI Jingya;JIAO Dongliang(Department of Psychiatry,Bengbu First People's Hospital,Bengbu,Anhui 233000,China;不详)

机构地区：[1]蚌埠市第一人民医院精神卫生科,安徽蚌埠233000 [2]蚌埠医科大学精神卫生学院,安徽蚌埠233000

出　　处：《中华全科医学》2024年第9期1567-1570,共4页Chinese Journal of General Practice

基　　金：蚌埠医学院科技重点项目(2020byzd366);安徽省卫生健康科研重点项目(AHWJ2022a029)。

摘　　要：目的探讨首发抑郁障碍患者前额叶磁共振波谱的特征,并进一步分析质子磁共振波谱分析(~1H-MRS)指标对首发抑郁障碍的诊断价值。方法2021年1月—2022年12月在蚌埠市第一人民医院随机选取满足入组标准和排除标准的首发抑郁障碍患者40例作为研究组,随机选取蚌埠市第一人民医院体检中心40名健康者作为对照组,采用超导型磁共振成像系统采集研究对象的^(1)H-MRS指标,采用自编的一般情况问卷收集研究对象的一般情况资料,将收集的数据整理并录入数据库,运用SPSS 20.0统计学软件对数据进行χ^(2)检验、成组t检验,并构建ROC曲线。结果(1)研究组与对照组比较,2组性别、受教育程度、婚姻、独生子女和年龄的分布差异均无统计学意义(P>0.05);(2)研究组N-乙酰基天门冬氨酸(NAA)/肌酸复合物(Cr)值(1.74±0.73)低于对照组(2.03±0.48),差异有统计学意义(P<0.05),研究组胆碱复合物(Cho)/Cr值(1.07±0.53)低于对照组(1.11±0.31),差异无统计学意义(P>0.05);(3)以NAA/Cr值为检验变量,研究组和对照组的分组为状态变量(研究组=1,对照组=0)构建ROC曲线,NAA/Cr值对首发抑郁障碍有一定的预测作用(AUC=0.664,P=0.012)。结论首发抑郁障碍患者前额叶神经元功能低下,NAA/Cr值显著减低,NAA/Cr值作为客观指标对首发抑郁障碍有一定的诊断价值。ObjectiveTo analyze the characteristics of prefrontal lobe proton MR spectroscopy(^(1)H-MRS)in patients with first-episode depressive disorder and evaluate its diagnostic value.MethodsFrom January 2021 to December 2022,40 patients with first-episode depressive disorder who met the criteria and exclusion criteria were randomly selected as the study group according to the medical record number in the Bengbu First People's Hospital,while 40 healthy persons were randomly selected in Bengbu First People's Hospital Physical Examination Center as the control group.The1H-MRS indexes of the subjects were collected by superconducting magnetic resonance imaging system.The general information of the study subjects was collected using a self-made general situation questionnaire.The collected data was organized and entered into the database.The chi square test,independent sample t-test and construct ROC curve on the data were analyzed by SPSS 20.0. Results(1)There was no significant difference in the distribution of sex,education,marriage,only child status,or age between the study group and the control group(P>0.05).(2)The value of N-acetyl-based aspartate acid(NAA)/creatine(Cr)(1.74±0.73)in the study group was significantly lower than that in the control group(2.03±0.48,P<0.05),while there was no significant difference in choline complex(Cho)/Cr between the study group(1.07±0.53)and the control group(1.11±0.31,P> 0.05).(3)Using NAA/Cr value as the test variable,and the study group and control group as state variables(study group=1,control group=0),ROC curves were constructed.NAA/Cr value demonstrated a certain predictive effect for first-episode depressive disorder(AUC=0.664,P=0.012).ConclusionPatients with first-onset depression show significantly reduced NAA/Cr values and decreased neuronal function in the frontal lobe.NAA/Cr is a valuable objective indicator for diagnosing first-onset depression.

关 键 词：首发抑郁障碍 磁共振波谱 前额叶 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]