青少年抑郁症患者额叶、海马及丘脑的1H-MRS分析研究

目的探讨青少年抑郁症患者额叶、海马及丘脑部位的神经生化代谢物质水平变化。方法利用质子磁共振波谱分析（1H-MRS）技术分别定量分析28例青少年抑郁症患者（抑郁组）和28例健康青少年（对照组）的前额叶皮质、海马及丘脑中生化代谢物质N-乙酰天门冬氨酸（NAA）、胆碱复合物（Cho）、谷氨酸复合物（Glx）、肌酸复合物（Cr2、Cr）及肌醇（mI）的水平,并计算NAA/Cr、Cho/Cr、GLx/Cr、mI/Cr、Cr2/Cr的值。结果抑郁症组双侧前额叶皮质和海马组织的NAA/Cr值均明显低于正常对照组（P〈0.01或P〈0.05）。抑郁症组双侧前额叶皮质Cho/Cr值均高于正常对照组（P〈0.05或P〈0.01）。右侧额叶和右侧海马的Glx/Cr值均低于正常对照组（P〈0.05）,差异有统计学意义。右侧海马mI/Cr值高于正常对照组（P〈0.05）。丘脑中各种代谢物的相对含量在抑郁症组与对照组间的比较,差异不显著（P〉0.05）。结论青少年抑郁症患者的额叶和海马是发病过程中的主要影响部位,其中NAA水平的变化与抑郁症的发生最为密切。

The 1H-MRS Analysis of Frontal Lobe,Hhippocampus and Thalamus in Patients with Adolescent Depressed

Objective To explore the changes of neural biochemical metabolites of frontal lobe, hippocampus and thalamus in patients with adolescent depression. Methods The Biochemical metabolites of frontal lobe, hippocampus and thalamus cortex, such as prefrontal ammonia acid （NAA）, choline （Cho）, glutamate complex （Glx）, creatine compounds （Cr2, Cr） and inositol （mI） of 28 adolescent depression patients （depression group） and 28 healthy adolescents （control group） were quantitative analyzed by the proton magnetic resonance spectroscopy （1H-MRS） technique respectively. And the value of NAA/Cr, Cho/Cr, GLx/Cr, mI/Cr, Cr2/Cr were counted. Results The NAA/Cr values of bilateral prefrontal cortex and hippocampus of the depression group were significantly lower than those in normal control group （P〈0.01 orP〈0.05）.The Cho/Cr values of bilateral prefrontal cortical of the depression group were higher than those in normal control group （P〈0.01 or P〈0.05）.The right frontal lobe and the right hippocampus Glx/Cr values were lower than the normal control group （P〈0.05）, the difference was statistically significant.The right hippocampus mI/Cr value was higher than the normal control group （P〈0.05）. The difference of relative contents of various metabolites in the thalamus between depression group and control group was not significant （P〉0.05）. Conclusion The main effect of the adolescent depression area are frontal lobe and hippocampus, and the changes of NAA level is closely relate to the occurrence of depression.