脑卒中后抑郁患者的波谱研究

目的：探讨M RS定量测定在预测梗塞后抑郁中的价值。方法对51例首发脑卒中且预后良好的患者和15例健康志愿者进行1 H‐M RS。根据DSM‐IV抑郁性疾患诊断标准和 HDRS评分，将所有脑卒中患者分为3组，然后分析卒中后抑郁患者与未受梗塞灶累及的额叶（前扣带回）1 H‐MRS数据之间的关系。采用单体素 MRS来评价额叶 NAA／Cr ，Glu／Cr ，Cho／Cr和mI／Cr的值。结果共11例患者（21．5％）符合抑郁症的诊断标准，9例（17．6％）患者的 HDRS评分＞14、但不符合抑郁症的诊断标准，这两组例患者的Glu／Cr值都高于 HDRS评分＜14的卒中患者和健康志愿者（ P＜0．001）。但是NAA／Cr、Cho／Cr和mI／Cr的值在卒中后各组之间无明显统计学差异。结论研究表明卒中后抑郁症的患者其额叶Glu的水平发生了变化。

The study of metabolize in patients with post-stroke depression using MRS

Objective To explore the value of MRS in the prediction of patients with post‐stroke depression .Methods A group of 51 patients who experienced stroke for the first time and had a good prognosis and 15 healthy volunteers were enrolled in this study .According to the scores by using the DSM‐IV diagnostic criteria for major depressive disorder and the 17‐item hamilton depression rating scale （HDRS） ,the patients with cerebral infarction were classified into 3 groups . We analyzed the association between post‐stroke depression and 1 H‐MRS measurements in unaffected frontal lobes .Single‐voxel proton magnetic resonance spectroscopy （1 H‐MRS） was performed to assess N‐acetylaspartate/creatine （NAA）/Cr , glutamate （Glu）/Cr ,choline （Cho）/Cr ,and myoinositol （mI）/Cr ratios in stroke patients .Results 11 patients （21 .5% ） who met the criteria for depression and 9 patients （17 .6% ） who had a high score for HDRS （〉 14） ,but were not de‐pressed ,had a significantly higher Glu/Cr ratio than patients who scored ≤14 on HDRS and control groups （ P〈0 .001） . No differences were found in NAA/Cr ,Cho/Cr ,or mI/Cr between the groups after stroke .Conclusion Post‐stroke de‐pression is accompanied by changes in glutamate levels in the frontal lobe .