抑郁症状与SPECT局部脑血流灌注的相关探讨

 [目的]采用单光子发射计算机断层扫描（SPECT）技术测定抑郁症患者的局部脑血流（rCBF）,与正常对照比较脑血流灌注变化,并观察抑郁症症状与患者脑血流灌注的关系。[方法]以18例未经抗抑郁治疗的抑郁症患者为研究对象,19名正常人作为对照组,分别行SPECT检查。[结果]未经治疗的抑郁患者SPECT脑血流低灌注发生率为72.2%;重症抑郁患者100%存在脑血流低灌注;抑郁组患者双侧额叶、颞叶的rCBF较对照组显著下降（P〈0.01～0.05）,左顶叶、右基底节rCBF也明显降低（P〈0.05）;抑郁组内左、右侧脑血流低灌注存在不对称性,左侧额叶、顶叶的rCBF较右侧显著下降（P〈0.01）,颞叶的rCBF也较右侧下降（P〈0.05）;左、右额叶局部脑血流与抑郁迟缓（P〈0.01）、日夜变化（P〈0.05）因子呈负相关;焦虑/躯体化因子与右额叶（P〈0.05）、右基底节（P〈0.01）血流灌注呈负相关。[结论]未经治疗的抑郁症患者存在某些特定部位脑血流灌注下降;左侧脑血流灌注减低更多见;脑血流灌注与生物学抑郁症状有关,伴有生物学症状的抑郁症患者可能有脑部血流低灌注。

Cerebral Blood Flow Perfusion in Patients with Depressive Disorder Associated with Depression Using SPECT

Objective To investigate the regional cerebral blood flow (rCBF) by using SPECT in the patients with depressive disorder and controls,and to observe the relationship between the rCBF and depressive symptoms. Method Eighteen non-medicated patients fulfilling the CCMD-3 criteria for depressive disorder and nineteen healthy control subjects were included. SPECT was performed in the patients and the control subjects. Results The rate of low perfusion of rCBF in the patients with depressive disorder was 72.2%; 100% in the patients with major depressive disorder were showed low perfusion of rCBF in SPECT. The difference between the untreated depressed patients and the controls was significant,indicating relatively reduced perfusion on left and right side of frontal lobe,temporal lobe(P< 0.01~0.05),left parietal lobe,right basal ganglia(P< 0.05) in depressed patients than control subjects. Additionally,we observed a significant asymmetry of rCBF between the left and right side. The perfusion of rCBF within the patients was significantly lower in frontal(P< 0.01),temporal(P< 0.05) and parietal(P< 0.01) cortical regions of the left side than those of right side. The rCBF of both side frontal lobe was negtively associated with retardation factor(P< 0.01) and diurnal variation factor(P< 0.05) of depressive symptom,anxiety/somatization factor was negtively associated with rCBF of right frontal lobe(P< 0.05) and right basal ganglia(P< 0.01). Conclusion The low perfusion of rCBF in SPECT was found in non-medicated patients with depressive disorder. The perfusion of rCBF was significantly lower on left brain hemisphere than right brain hemisphere. The perfusion of rCBF associated with biological depressive symptoms,the patients with biological features of depressive symptoms may be associated with low perfusion of rCBF diagnosed in SPECT.