肠易激综合征患者的情绪障碍及机制探讨

目的研究肠易激综合征患者抑郁、焦虑发生情况及其发生的病理生理机制。方法对50例肠易激综合征患者和50例正常对照者进行抑郁自评(SDS)、焦虑自评(SAS)及艾森克个性问卷(EPQ);并将抑郁、焦虑评分与局部脑血流灌注量进行相关分析。结果 1)肠易激综合征患者抑郁发生率为76%,焦虑发生率为46%;健康对照组无抑郁发生,焦虑发生率为2%(1/50)。肠易激综合征患者抑郁、焦虑发生率及其SDS评定平均标准分均明显高于健康对照组(P<0.001)。2)IBS患者的抑郁评分与左侧屏状核,左侧豆状核、右侧直回、右侧钩回血流灌注呈负相关,与左侧楔叶、两侧楔前叶、左侧枕上回、右侧缘上回、右侧顶下小叶血流呈正相关;焦虑评分与左侧屏状核、左侧岛叶血流呈负相关。结论肠易激综合征患者存在明显抑郁、焦虑情绪;局部脑血流灌注异常可能是其发生情绪障碍的病理生理机制之一。

Study on mood disorders and its mechanisms in patients with irritable bowel syndrome

Objective The mood change and its related factors were analyzed in patients with irritable bowel syndrome(IBS) to explore its possible pathophysiological mechanism.Methods Mood changes were assessed with Self-Rating Depression Scale(SDS) for depression and Self-Rating Anxiety Scale(SAS) for anxiety in 50 patients with hyperthyroidism and 50 healthy controls.The correlations were done between SDS,SAS scores and regional cerebral blood flow perfusion(rCBF) of IBS patients.Results 76 percent of the patients had depression and 46% had anxiety.Healthy controls had no depression and 2% anxiety happened.IBS patients with depression,anxiety and average standard marks of SDS and SAS were significantly higher than that in the healthy control group(P<0.05).There were negative correlations between scores of depression and rCBF in left claustrum,left lentiform,right rectus gyrus and right uncus;and negative correlation between scores of depression and rCBF in left cuneus,bilateral precuneus,left superior occipital gyrus,right superior marginal gyrus and right inferior parietal lobe.Regional cerebral blood flow in left lentiform and 1eft insula were negatively correlated with of anxiety.Conclusion Depression and anxiety are found in patients with IBS.Abnormal cerebral blood flow perfusion might be one of the possible mechanisms of mood disorders in patients with IBS.