强迫症与焦虑症、抑郁障碍脑单光子发射计算机断层扫描对照研究

目的　探讨强迫症患者局部脑血流量 (rCBF)特点及脑单光子发射计算机断层扫描 (SPECT)对强迫症诊断的价值。方法　对 13例强迫症患者、19例正常对照、7例焦虑症和 5例抑郁障碍进行脑SPECT检查 ,并比较检查结果。结果　强迫症患者左颞枕叶SPECT放射性记数比值明显低于正常对照组 (P <0 .0 5 ) ;轻、重度强迫症患者左右两侧尾状核SPECT放射性记数比值的差值具有显著性差异 (P <0 .0 5 ) ;强迫症患者大脑皮层前额叶、额颞叶、颞前叶、颞枕叶、枕前叶等部位 ,左侧脑血流灌注低于右侧 (P <0 .0 1或P <0 .0 5 ) ;强迫症组与焦虑症组相比 ,左侧颞枕叶和两侧枕前叶的SPECT放射性记数比值均较低 (P <0 .0 1或P <0 .0 5 ) ,而与抑郁障碍组相比 ,任一脑区均无显著性差异 (P >0 .0 5 )。结论　强迫症可能存在颞叶、尾状核功能障碍 ,大脑皮层脑血流灌注明显不对称 ;强迫症脑血流灌注与焦虑症差异明显 ,而与抑郁障碍无显著差异。

A comparative study of single photon emission computed tomography between patients with obsessive-compulsive disorder'''' anxiety disorder and depressive disorder

Objective To explore the characteristics of the regional cerebral blood flow(rCBF) and the diagnostic value of brain SPECT in patients with obsessive-compulsive disorder(OCD). Methods SPECT were performed in 13 OCD subjects,19 normal subjects,7 patients with anxiety disorder and 5 patients with depressive disorder to compare the difference in cerebral perfusion. Results The value in SPECT radioactive counts ratio in left temporoccipital lobe was lower in OCD patients than in normal subjects( P < 0.05 ).The difference of the ratio of SPECT between left and right cerebral was significantly different between severe and mild OCD patients in posterior caudate nucleus( P <0.05).The rCBF of left cortex was significantly lower than of right cortex( P <0.05 or P <0.01).Compared with anxiety disorder, the rCBF ratio of left temporoccipital lobe and both left and right antoccipital lobe were significantly lower in OCD patients( P <0.05 or P <0.01). There was no significantly difference of rCBF ratio in every region of interest(ROI) between OCD patients and depressive disorder( P >0.05). Conclusion There are functional disorder in temporal lobe and caudate nucleus in OCD patients. The cerebral perfusion in cortex is obvious asymmetry. The cerebral perfusion in OCD is different from anxiety neurosis, but not from depressive disorder.