抑郁症患者脑代谢功能改变的磁共振波谱分析

目的利用磁共振波谱评价抑郁症患者是否存在认知相关脑功能区代谢物的异常改变以及MRS代谢指标同认知测试之间的相关性。方法选择我院收治的18例首次发作的抑郁症患者作为B组．10例复发的抑郁症患者做C组，另外选取12例正常志愿者A组作为研究对象，均于MR检查前接受威斯康星卡片分类测试，记录结果；之后再接受双侧前侧叶及扣带回的HRS，记录N乙酰天门冬氨酸、胆碱、肌醇、谷氨酸和谷氨酰胺复合物曲线面积的比值计算。分析二者之间的关系。结果与A组相比，C组Glx/Cr 减低，mIns／Cr升高，两组患者Glx/Cr减低，右侧前额叶mIns／Cr升高；B组、C组均存在WCST中完成总应答数、持续错误数和非持续错误数增加。B组、C组患者双侧前额叶Glx/Cr与持续错误数均呈负相关。结论抑郁症患者均存在双侧前额叶的异常代谢变化级认知功能等障碍，抑郁症患者认知障碍的病理生理学基础可能是谷氨酸能系统异常引起的。

Magnetic resonance spectroscopy observation on brain metabolic changes in patients with depression

Objective To use magnetic resonance to evaluate depression patients whether there are cognitive related brain function abnormal changes of metabolites and MRS metabolic indices and the relationship between cognitive tests. Methods Eighteen cases were selected as the first onset depression patients as group B, 10 cases of recurrent depression patients as group C,in additional selected 12 cases of normal volunteers as group A,with research object, in all MR checked before accepted Wisconsin card sorting test,record results;then accepted double side of the side lobe and cingulate gyrus of HRS,recorded N acetyl aspartic acid, choline, inositol, glutamic acid and glutamine complex curve area ratio calculation. Analyzed the relationship between two functions. Results Compared with group A and group C double side prefrontal Glx/Cr,reduced mIns/Cr increases,two groups of double side prefrontal Glx/Cr reduced,right prefrontal mIns/Cr rise ;Group B, C group there were completed in WCST should always be responsible number for wrong number and non continuous error number increase. Group B patients right prefrontal Glx/CR and continued wrong number was negatively correlated, C group of patients with bilateral prefrontal Glx/CR and continued wrong number were negatively related. Conclusion Patients with depression has double side prefrontal abnormal metabolic changes level cognitive dysfunction, glutamic acid can system anomaly may be depressed patients cognitive impairment pathological physiological basis.