抑郁症患者脑血流速度与严重程度、认知功能的关系

目的探讨抑郁症患者脑血流速度与抑郁症严重程度、认知功能的相关性。 方法选取抑郁症患者68例作为观察组，健康体检者80例作为对照组。采用经颅多普勒超声（transcranial Doppler，TCD）分析2组大脑基底动脉（basilar artery，BA）、左右大脑椎动脉（vertebral artery，VA）、左右大脑前动脉（anterior cerebral artery，ACA）、左右大脑中动脉（middle cere-bral artery，MCA）、左右大脑后动脉（posterior cerebral artery，PCA）的血流速度，汉密尔顿抑郁量表（items Hamilton depression scale，HAMD）评估抑郁症患者的抑郁严重程度，采用划销测验（cancellation test，CT）、威斯康星卡片分类测验（Wisconsin cardsorting test，WCST）评估2组认知功能，Pearman分析抑郁症患者脑动脉血流速度与抑郁症严重程度、认知功能的相关性。 结果观察组HAMD评分明显高于对照组，差异有统计学意义(P＜0.05)。观察组CT评分各项净分及总净分均显著低于对照组，WCST评分总应答数、错误应答数、持续错误数、第1个分类应答完成数均显著高于对照组，差异有统计学意义(P＜0.05)。观察组BA、左右MCA、左右ACA血流速度均显著低于对照组，差异有统计学意义(P＜0.05)。2组左右VA、左右PCA血流速度差异均无统计学意义（P＞0.05）。Pearson相关性分析结果显示，BA、右MCA血流速度与CT总净分呈显著正相关，左ACA、右ACA血流速度与CT总净分呈显著负相关，BA、左ACA、右ACA血流速度与WCST总应答数呈显著负相关，左ACA、右ACA血流速度与持续性错误数呈负相关，右ACA血流速度与第1个分类应答完成数呈负相关(P＜0.05) 。 结论抑郁症患者脑动脉血流速度低于健康群体，其注意力、执行功能也显著降低，但未发现与抑郁症严重程度有显著相关性，可从患者的认知功能损伤程度角度探究其脑血流速度改变的影响因素。

Relationship of cerebral blood flow velocity to severity and cognitive function in patients with depression

ObjectiveTo investigate the correlation of the cerebral blood flow velocity with the severity of depression and cognitive function of patients with depression. MethodsA total of 68 patients with depression were selected as the observation group and 80 healthy people who underwent physical examination were enrolled as the control group. Transcranial Doppler(TCD) was used to analyze the cerebral artery blood flow velocity of basilar artery(BA), left and right cerebral vertebral artery(VA), left and right anterior cerebral artery(ACA), left and right middle cerebral artery(MCA), and left and right posterior cerebral artery(PCA).The Hamilton depression scale(HAMD) was used to assess the severity of depression in the patients. The cognitive function of the two groups was assessed by the cancellation test(CT) and the Wisconsin cardsorting test(WCST). Pearson correlation analysis was used to analyze the correlation of cerebral blood flow velocity with depression severity and cognitive function of patients with depression. ResultsThe HAMD score of the observation group was significantly higher than that of the control group, with significant differences(P＜0.05). The net scores and total net scores of CT evaluations of patients in the observation group were significantly lower than those of the control group. The total number of WCST score responses, the number of error responses, the number of persistent errors, and the completion of the first classification response were significantly higher than those of the control group, suggesting significant difference between the groups( P＜0.05). The blood flow velocities of the BA, left and right MCA, and left and right ACA of the observation group were significantly lower than those of the control group, and the difference between the groups was statistically significant(P＜0.05). There was no significant difference in the blood flow velocities of the VA and left and right PCA(P＞0.05). According to the Pearman correlation analysis results, the blood flow velocity of BA and right MCA was significantly positively correlated with the total net score of CT, while the blood flow velocity of left ACA and right ACA was significantly negatively correlated with the total CT score. The blood flow velocity of BA, left ACA, and right ACA was significantly negatively correlated with the total number of WCST responses, the blood flow velocity of left ACA and right ACA was negatively correlated with the number of persistent errors, and that of right ACA was negatively correlated with the number of the completion of the first classification response(P＜0.05). ConclusionThe cerebral artery blood flow velocity of depression patients was lower than that of healthy groups, and their attention and executive function were also significantly reduced, which, however, were not significantly correlated with the severity of depression. The influencing factors of the changes in cerebral blood flow velocity can be explored from the perspective of the degree of cognitive impairment of depression patients.