自杀未遂抑郁症患者海马代谢物水平的磁共振波谱研究

目的 探讨自杀未遂抑郁症患者海马磁共振质子波谱(1H-MRS)的代谢特点.方法 应用1H-MRS成像系统检测24例自杀未遂抑郁症患者和24名健康对照双侧海马N-乙酰天冬安酸(NAA)、胆碱复合物(Cho)、肌醇(mI)和肌酸(Cr)等4种代谢产物,分别计算海马双侧NAA/Cr、Cho/Cr以及mI/Cr比值,作为反映NAA、Cho和mI水平的评估指标.分析患者组和对照组之间代谢指标的组间差异性;利用组内代谢指标双侧比较,结合单侧化指数分析海马代谢的左右对称性.结果 自杀未遂抑郁症组左侧海马NAA/Cr(1.50±0.20)明显低于对照组(1.80±0.16),差异具有显著性(P<0.05).对照组左侧海马NAA/Cr明显高于右侧(1.45±0.15),差异具有显著性(P<0.05),自杀未遂抑郁症组左右两侧海马NAA/Cr差异无显著性(P>0.05).单侧化指数分析显示,对照组双侧海马NAA/Cr具有不对称性(LNAA/Cr=1.09±0.03,P<0.05),自杀未遂抑郁症组双侧海马NAA/Cr不对称性(P>0.05).自杀未遂抑郁症组任何代谢指标与疾病病程、发作次数、疾病严重程度(HAMDl7评分)和药物使用无显著相关性(P>0.05).结论 自杀未遂抑郁症左侧海马代谢下降,双侧海马代谢不对称性消失.

A proton magnetic spectroscopy research on hippocampus in suicide-attempted depression

Objective To investigate the metabolic features of hippocampus in suicide-attempted depression by proton resonance spectroscopy(1H-MRS). Methods 1H-MRS was performed on bilateral hippocampi in 24 suicide-attempted depressions and 24 healthy controls. The ratios of N-acetylasparte (NAA)/creatine (Cr),choline(Cho)/Cr and myoinositol (mI)/Cr were calculated, and were used as observation marker reflecting the metabolic level of NAA, Cho and mI. The differences among all maskers in bilateral hippoeampi between the suicide-attempted depression and the control were analyzed. And differences between the left hippocampus and the right among all metabolic markers and lateralization index were used to determine the asymmetry of hippocampus metabolic. Results The ratio of NAA/Cr in the left hippocampus in suicide-attempted was significantly decreased than that in the control ( P < 0.05 ). The ratio of NAA/Cr in left hippocampus was significantly greater than that in right hippocampus in the control ( P < 0.05 ), the deference of the ratio of NAA/Cr between the left and right hippocampus in the suicide-attempted depression was not significant. There was an asymmetry between the left and the right in ratio of NAA/Cr in the control by using lateralization index analysis ( P < 0.05 ) ,but there was not in the suicide-attempted depression( P > 0.05). No correlations among all metabolic markers with the course of disease, number of episodes and HAMD17 scores and drug usage was found in the suicide-attempted depression( P>0.05). Conclusion Metabolite of NAA/Cr in left hippocampus decreased and an asymmetry of bilateral hippocampi can not be seen in the suicide-attempted depression.