强迫症与抑郁症的脑单光子发射计算机断层扫描对照研究

目的探讨强迫症、抑郁症局部脑血流量(rCBF)特点。方法应用单光子发射计算机断层扫描(SPECT)技术,对首发且未经治疗的39例强迫症患者、36例抑郁症患者和39名正常人于静息状态下行脑血流显像。以小脑皮质的放射性计数值为参考,对局部脑血流进行半定量分析。结果强迫症组两侧前额叶、前颞叶rCBF高于正常组(P<0.01);抑郁症组两侧前额叶、枕叶、扣带回及右前颞叶、右顶叶rCBF低于正常组(P<0.05);在两侧前额叶、前颞叶、顶叶、枕叶及右后额叶、扣带回,强迫症组rCBF高于抑郁症组(P<0.05)。结论强迫症组的前额叶及前颞叶呈高灌注改变,抑郁症组脑血流普遍低灌注,SPECT技术可望作为二者鉴别诊断的客观依据之一。

The study of single photo emission computed tomography in patients with obsessive-compulsive disorder and those with depressive disorder

Objective To study single photo emission computed tomography(SPECT) features in patients with obsessive-compulsive disorder(OCD) and those with depressive disorder.Methods 99mTc-ECD brain SPECT imaging was performed in 39 untreated patients with OCD,36 untreated patients with depressive disorder and 39 normal controls.Results The rCBF in prefrontal lobe and pretemporal lobe were higher in OCD than in normal subjects(P<0.01).Compared with controls,there were decreases in rCBF in prefrontal lobe,cingulate gyrus and right temporal lobe,parietal lobe,occipital lobe in depressive patients(P<0.01 or P<0.05).The rCBF in the prefrontal lobe,pretemporal lobe,parietal lobe,cingulated and occipital lobe were higher in OCD group than in depressive patients(P<0.01 or P<0.05).Conclusions Patients with OCD have high cerebral perfusion in the frontal lobe and temporal lobe,whereas patients with depressive disorder have low cerebral perfusion in the whole cortex.The cerebral perfusion in OCD is different from depressive disorder.Brain SPECT imaging may be useful for differentiating OCD from depressive disorder.