摘要
目的:探讨首发左侧基底节脑梗死患者左前额叶白质、梗塞区质子磁共振波谱(1H-MRS)的变化,及其与脑梗死后抑郁(PSD)、神经功能缺损、日常生活能力的关系。方法:首发左侧基底节脑梗死患者以及健康对照者在发病1周和1月时行1H-MRS扫描,采集N-乙酰门冬氨酸(NAA)、胆碱(Cho)、肌酐(Cr)波谱图。并在1周、1个月、6个月时行汉密尔顿抑郁量表(HAMD)、美国国立卫生院神经功能缺损评分(NIHSS)、日常生活能力量表评分(ADL)。根据HAMD结果分为PSD组和非脑梗死后抑郁(NPSD)组,比较各组间1H-MRS代谢物值差异,及其与NIHSS、ADL的相关性。结果:共纳入22例左侧基底节脑梗死患者,其中10例诊断为PSD、12例为脑梗死后非抑郁(NPSD),10例健康对照者。1H-MRS显示脑梗死后1周和1个月,左前额叶白质区和左侧基底节区NAA/Cr较正常组降低(P<0.05),Cho/Cr较正常组明显升高(P<0.05),PSD患者的NAA/Cr较NPSD组更低(P<0.05),而Cho/Cr较NPSD患者高(P<0.05)。1个月时PSD组左前额叶白质NAA/Cr与NIHSS相关(r=-0.551,P=0.032);Cho/Cr与ADL相关(r=0.682,P=0.005)。结论:基底节脑梗死后PSD者1H-MRS的代谢物变化明显,可能对早期预测PSD有价值。
Objective： To investigate the metabolic spectroscopy （1H-MRS） in patients with first left basal changes on proton magnetic resonance ganglia infarction and their relationship with depression. Methods：Twenty-two patients with first left basal ganglia infarction and 10 matched healthy controls were recruited in the study. Patients and controls underwent 1H MRS scan and the spectrum of N- acetyl aspartic acid （NAA）, choline （Cho） and creatinine （Cr） was recorded at the first week （D7） and 1 month after onset （ M1 ）, respectively. National Institutes of Health Stroke Scale （ NIHSS ）, Ability of daily life （ADL）, Hamilton Depression Scale （HAMD） were evaluated at I）7 ,M1 and M6 after onset. The patients were classified into two groups： post-stroke depression （PSD） and non-post-stroke depression （NPSD） according to the result of HAMD. The differences of 1H-MRS between these two groups were compared and their relationship with NIHSS and ADL was analyzed. Results： Among 22 patients 10 were diagnosed as PSD and 12 were NPSD. Compared to controls, NAA/Cr was significantly lower and Cho/Cr was significantly higher （ P 〈 0.05 ） in left prefrontal white matter and left basal ganglia in patients with infarct. Patients with PSD showed a lower NAA/Cr and higher Cho/Cr than NPSD patients （ P 〈 0.05 ）. At M1 after onset, NAA/Cr in the left prefrontal white matter was significantly correlated with NIHSS （ r = -0.551, P = 0.032）, while Cho/Cr was correlated with ADL （ r = 0. 682, P = 0. 005 ） in PSD patients. Conclusion ： Metabolic changes shown on 1H-MRS in patients with basal ganglia infarction may predict the occurrence of PSD.
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2013年第2期205-211,共7页
Journal of Zhejiang University(Medical Sciences)
关键词
基底神经节疾病
诊断
额叶
病理学
脑梗死
诊断
抑郁症
并发症
磁共振波谱学
方法
质子
诊断应用
Basal ganglia diseases/diagnosis
Frontal lobe/pathology
Brain infarction/diagnosis
Depressive disorder/complications
Magnetic resonance spectroscope/methods
Protons/diagnostic use
