卒中后抑郁患者海马磁共振氢质子波谱分析

目的 探讨卒中后抑郁患者海马氢质子磁共振波谱（1H-MRS）的特点.方法 以32例卒中后抑郁患者为研究组,30例脑卒中患者为病例对照组,30名正常人为正常对照组.三组在入组24 h内采用多体素1 H-MRS检测双侧海马N-乙酰基天门冬氨酸（NAA）、胆碱复合物（Cho）与肌酸复合物（Cr）,完成NAA/Cr值和Cho/Cr值的计算.结果 研究组左右侧海马NAA/Cr值均低于病例对照组和正常对照组,P均＜0.05;研究组左侧海马Cho/Cr值均高于病例对照组和正常对照组,P均＜0.05;右侧海马Cho/Cr值高于正常对照组（P＜0.05）,但与病例对照组比较,P＞0.05.重度抑郁组左右侧海马NAA/Cr值均低于轻度抑郁组,P均＜0.05;不同抑郁程度的双侧海马Cho/Cr值比较,P均＞0.05;研究组双侧海马NAA/Cr值与HAMD评分呈负相关（P均＜0.05）,而双侧海马Cho/Cr值与HAMD评分不存在相关关系（P＞0.05）.三组左右两侧海马各研究指标比较,P均＞0.05.结论 海马神经元代谢的异常可能是卒中后抑郁的神经生物学基础;卒中后抑郁患者、脑卒中患者和正常人脑部NAA、Cho可能并不存在侧化现象.

Analysis of proton magnetic resonance spectroscopy imaging on hippocampus in patients with post-stroke depression

Objective To analysis the characteristics of proton magnetic resonance spectroscopy （1 H-MRS） on hippocampus in patients with post-stroke depression.Methods A total of 32 patients with post-stroke depression （research group）,30 patients with stroke （case-control group） and 30 normal controls （control group） were assessed in this study.A multi-voxel 1H-MRS was given to all the subjects on hippocampus within 24 hours they got in hospital.The NAA,Cho and Cr were measured and the ratios of NAA/Cr and Cho/Cr were determined.Results In left and right hippocampus,the NAA/Cr ratio in research group demonstrated lower than that in other two groups.In left hippocampus,the Cho/Cr ratio in research group showed higher than that in other two groups （P ＜ 0.05） ; in right hippocampus,the Cho/Cr ratio was higher than that in other two groups （P ＜ 0.05）.In left and right hippocampus,the NAA/Cr ratio in the severe depression group was lower than that in the mild depression group （P ＜ 0.05）,there was no significant difference in the Cho/Cr ratio among the different degree of depression （P ＞ 0.05）.In left and right hippocampus,the NAA/Cr ratio in research group showed a significant negative correlation with the HAMD scores （P ＜ 0.05） ; the Cho/Cr ratio not showed a significant correlation with The HAMD scores （P ＞ 0.05）.In the three groups,there were no significant differences in NAA/Cr and Cho/Cr between bilateral hippocampus （P ＞ 0.05）.Conlusions Abnormal metabolism of hippocampal neurons maybe the neurobiological basis of post-stroke depression.There is no significantly lateralized asymmetry for metabolite levels such as NAA,Cho among post-stroke depression,stroke patients and normal subjects.