基于杏仁核亚区CBF的阈下抑郁和首发重度抑郁症的危险因素分析  

Analysis of risk factors for subthreshold depression and first-episode major depressive disorder based on CBF of amygdala subregion

作　　者：张宁宁 王云 徐成 刘可夫[1] ZHANG Ningning;WANG Yun;XU Cheng;LIU Kefu(Gusu School,Nanjing Medical University/The Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital,Suzhou 215002,China;Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201799,China)

机构地区：[1]南京医科大学姑苏学院,南京医科大学附属苏州医院,苏州市立医院,江苏苏州215002 [2]复旦大学附属中山医院青浦分院,上海201799

出　　处：《中国实用神经疾病杂志》2025年第1期7-12,共6页Chinese Journal of Practical Nervous Diseases

基　　金：苏州市“科教兴卫”青年科技项目(编号:KJXW2020042);上海市青浦区卫健委项目(编号:QWJ2022-18)。

摘　　要：目的探讨阈下抑郁(StD)和重度抑郁症(MDD)杏仁核各亚区脑血流量(CBF)变化,分析StD和MDD的危险因素。方法招募49例StD患者(StD组)、58例未经治疗的首发MDD患者(MDD组)和55例健康被试者(HC组),比较3组杏仁核(Amy)及其3个亚区[基底外侧核(LB)、中央内侧核(CM)、浅表核(SF)]CBF和外周血清炎性因子(IL-1β、IL-4、IL-6和TNF-α)水平,采用多分类Logistic回归分析评估StD和MDD的危险因素。结果3组被试者IL-1β和TNF-α水平、RAmy、RLB、RCM和LCM亚区的CBF存在统计学差异(P<0.05)。Logistic回归分析表明,RLB、RCM和LCM亚区的CBF变化是HC发展为StD的风险指标(P<0.05),TNF-α水平、RAmy和RCM亚区的CBF变化是HC发展为MDD的风险指标(P<0.05),RAmy、RLB和LCM亚区的CBF变化是StD进展为MDD的风险指标(P<0.05)。结论无抑郁状态下与阈下抑郁状态下发生重度抑郁症的高危因素存在差异,抑郁症的发生可能是一个涉及多个杏仁核亚区的动态变化过程,将有提高抑郁症检出率及监测其发生、发展的成效。Objective To investigate cerebral blood flow(CBF)in amygdalar subregions in subthreshold depression(StD)and major depressive disorder(MDD),and to analyze the risk factors for StD and MDD.Methods A total of 49 StD patients(StD group),58 untreated first-episode MDD patients(MDD group)and 55 healthy control subjects(HC group)were recruited.The CBF of the whole amygdala and its 3 subregions(laterobasal(LB),centromedial(CM)and superficial(SF)areas)and the levels of peripheral serum inflammatory factors(IL-1β,IL-4,IL-6,and TNF-α)were compared among the three groups.Multivariate Logistic regression analysis was used to evaluate the risk factors for StD and MDD.Results There were significant differences in IL-1βand TNF-αlevels and CBF in RAmy,RLB,RCM and LCM subregions among the three groups(P<0.05).Logistic regression analysis showed that the changes of CBF in the RLB,RCM and LCM subregions were risk indicators for HC progression to StD(P<0.05).TNF-αlevel,CBF changes in RAmy and RCM subregions were risk indicators for HC progression to MDD(P<0.05).CBF changes in RAmy,RLB,and LCM subregions were risk indicators for StD progression to MDD(P<0.05).Conclusion The present study shows that there are differences in the risk factors for MDD between the non-depression state and the subthreshold depression state.The occurrence of MDD may be a dynamic process involving multiple amygdala subregions,which will improve the detection rate of depression and monitor its occurrence and development.

关 键 词：阈下抑郁 亚临床抑郁 轻微抑郁 重度抑郁症 杏仁核亚区 基底外侧杏仁核 中央内侧杏仁核 浅表杏仁核 脑血流灌注 危险因素 

分 类 号：R749.41[医药卫生—神经病学与精神病学]