99Tcm-ECD SPECT局部脑血流显像乙酰唑胺试验对抑郁症的研究

目的观察乙酰唑胺负荷试验前后抑郁症患者局部脑血流(rCBF)的变化,评价其局部脑血管储备功能.方法以18例未经抗抑郁治疗的成年抑郁症患者为研究对象,18名年龄、性别匹配的正常志愿者作为对照组,进行99Tcm-双半胱乙酯(99Tcm-ECD)SPECT脑血流灌注断层显像,用半定量分析方法测定受检者的rCBF.在第一次检查后48 h,患者口服乙酰唑胺片2克,再行SPECT脑血流显像.结果抑郁症组患者双侧上、下部额叶,双侧前、后部颞叶,双侧顶叶、左侧基底节rCBF明显降低(P＜0.01);同时,左侧顶叶rCBF灌注比对侧更低(P＜0.01).服用乙酰唑胺后,原脑内低灌注区部位的rCBF均明显增高(P＜0.01),但没能恢复到正常水平(P＞0.05).结论抑郁症患者存在着不同部位和程度的rCBF灌注减低区,乙酰唑胺脑试验可使原来呈低灌注状态的rCBF明显提高.

Study on depression with 99Tcm-ECD SPECT regional cerebral blood flow imaging before and after acetazolamide test

Objective To observe the regional cerebral blood flow (rCBF) changes with Technetium-99m ethylcysteinate dimer ( 99 Tcm-ECD) single photon emission computed tomography (SPECT) in patients with depressive disorder before and after acetazolamide test and evaluate the patients' regional cerebral vessels reserve capacity. Methods Eighteen unmedicated adult patients fulfilling the CCMD-3 criteria for depressive disorder and 18 age-gender-matched healthy control subjects were included in the study. A initial baseline 99 Tcm-ECD brain SPECT were performed in both patient and control group. Reconstructed slices were evaluated semiquantitively by a semi-automatic rCBF analysis software. Two days later, the patients group was re-evaluated with the same way following taking orally 2 gram acetazolamide tablet for 2 h. Results The depressed patients showed significantly lower rCBF value in bilateral superior and inferior frontal cortex, bilateral anterior and posterior temporal cortex, bilateral parietal cortex, left basal ganglia region compared to those of controls (P<0.01). Furthermore, the rCBF of left parietal cortex in depressed patients was significantly lower (P<0.01) in comparison with the contralateral side. After acetazolamide stress test, rCBF of the hypoperfusion regions in baseline step were significantly increased (P<0.01), but not reached to the normal level of the controls (P>0.05). Conclusion The depressed patients showed different degree and position of lower rCBF perfusion regions. Acetazolamide stress test can significantly increase the rCBF of the hypoperfusion regions in baseline.