Graves病患者抑郁和焦虑状态及其脑血流量变化

目的探讨Graves病（GD）患者的精神状态、脑血流改变部位及两者之间的关系.方法对21例临床确诊为GD的右利手患者行Zung抑郁自评量表（SDS）、Zung焦虑自评量表（SAS）评分及SPECT局部脑血流（rCBF）显像,判定GD患者抑郁和（或）焦虑程度及rCBF改变部位.结果病例组与对照组SDS、SAS评分差异有显著性（t值分别为7.26、5.35,P均＜0.001）.90.5%（19/21例）的GD患者有抑郁和（或）焦虑症状,其严重程度与血清FT3、FT4及TSH无关.SPECT显像主要表现为额叶、颞叶、基底节及丘脑的放射性摄取减少,相应区域的rCBF降低百分比与SDS、SAS评分无关.结论GD患者伴随的精神症状较健康人群突出,其rCBF的降低多集中在双侧额叶、颞叶、基底节及丘脑.

Analysis of depression and anxiety state and changes of regional cerebral blood flow in patients with Graves'''' disease

Objective To explore the incidence of depression and anxiety state and the changes of regional cerebral blood flow(rCBF)in patients with Graves'disease(GD).Methods Twenty-one GD patients underwent rCBF SPECT imaging,and their mental state was evaluated by Zung self-rating depres- sion scale(SDS)and Zung self-rating anxiety scale(SAS)respectively.Results Total scores obtained from SDS and SAS were both significantly greater in the GD group than that in the control group(t_(SDS)= 7.26,t_(SAS)=5.35,P<0.001).90.5%(19/21)of GD patients had symptoms of depression and(or)anx- iety,but the severity was not correlative with FT_3,FT_4 and TSH levels.In SPECT imaging,GD group had decreased uptake of radioactivity in frontal lobs,temporal lobs,basal ganglia and thalamus mainly.There was also no significant correlation between the decrease of rCBF and SDS or SAS scores.Conclusions The psychiatric symptoms in GD group are more significant than normal controls,rCBF of GD group decreases mainly in bilateral frontal lobes,temporal lobes,basal ganglia and thalamus.