本文選題：雙相障礙 + 健康同胞　； 參考：《暨南大學(xué)》2015年碩士論文

【摘要】：研究目的:采用核磁共振波譜(Magnetic resonance spectroscopy,MRS)比較雙相抑郁(Bipolar depressive disorder,BDD)患者、患者的健康同胞(Healthy unaffected siblings,SIB)、健康對(duì)照者(Healthy controls,HC)三組間額葉皮質(zhì)、基底節(jié)和丘腦內(nèi)的腦生化代謝物差異,探討雙相障礙在在額葉皮質(zhì)、基底節(jié)和丘腦代謝物上可能的內(nèi)表型。對(duì)象和方法:擬入組受試者經(jīng)簡(jiǎn)明國(guó)際神經(jīng)精神障礙訪(fǎng)談(M.I.N.I.)行結(jié)構(gòu)化臨床會(huì)晤,使用美國(guó)《精神疾病的診斷和統(tǒng)計(jì)手冊(cè)》第四版(DSM-IV)進(jìn)行疾病診斷。共入組17例BDD患者、14例SIB和14例HC。受試者入組后接受量表測(cè)評(píng)、一般體格檢查和血液檢查,采用GE 3.0T Discovery MRI進(jìn)行大腦額葉皮質(zhì)、基底節(jié)和丘腦區(qū)靜息狀態(tài)下核磁共振波譜掃描,采集三個(gè)部位左右兩側(cè)的N-乙酰天門(mén)冬氨酸(N-acetylasparte,NAA)、膽堿復(fù)合物(Choline compounds,Cho)、肌醇(Myo-inositol,m I)、乳酸(Lactate,Lac)和肌酸(Creatine,Cr)水平。研究數(shù)據(jù)使用SPSS13.0統(tǒng)計(jì)分析軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1、HC組和SIB組的右側(cè)額葉皮質(zhì)區(qū)NAA/Cr水平顯著高于BDD組(F右=2.419,P右=0.000);2、HC組的左側(cè)額葉皮質(zhì)區(qū)NAA/Cr水平顯著高于BDD組和SIB組(F左=3.839,P左=0.029)3、SIB組及BDD組的左側(cè)額葉皮質(zhì)的Lac/Cr水平顯著高于HC組(F=4.797,P=0.013);4、BDD組及SIB組的左側(cè)基底節(jié)NAA/Cr水平顯著低于HC組(F=3.973,P=0.026);5、BDD組的左側(cè)基底節(jié)Lac/Cr水平與HAMD24項(xiàng)目呈正相關(guān)(r=0.590,P=0.013);6、BDD組年齡與右側(cè)丘腦區(qū)的Lac/Cr水平呈正相關(guān)(r=0.526,P=0.034);7、BDD組發(fā)作次數(shù)與左側(cè)丘腦m I/Cr水平呈負(fù)相關(guān)(r=-0.572,P=0.016);8、BDI組的右側(cè)基底節(jié)NAA/Cr水平顯著低于BDII組(t=-3.026,P=0.004)。結(jié)論:1、靜息狀態(tài)下,SIB的左側(cè)基底節(jié)和額葉存在NAA的下降和Lac的升高,可能可以參考為BD遺傳相關(guān)的內(nèi)表型標(biāo)記。2、BDD患者在左側(cè)基底節(jié)、雙額葉皮質(zhì)具有神經(jīng)元功能紊亂。3、BDI患者較BDII患者的基底節(jié)神經(jīng)損害更為嚴(yán)重。
[Abstract]:Objective: to compare the differences of brain biochemical metabolites in frontal cortex, basal ganglia and thalamus among patients with bipolar depressive disorder (BDD), healthy unaffected (healthy controls) and healthy controls (healthy controls) by magnetic resonance spectroscopy (MRSs). To investigate the possible endophenotypes of bipolar disorder in the frontal cortex, basal ganglia and thalamus metabolites. Participants and methods: participants in the proposed group underwent brief international interviews with neuropsychiatric disorders (M.I.N.I.) A structured clinical meeting was conducted to diagnose the disease using the fourth edition of the US Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). There were 14 cases of SIB and 14 cases of HCH in 17 patients with BDD. The subjects were assessed with the scale, general physical examination and blood examination. GE 3.0T Discovery MRI was used to scan the cerebral frontal cortex, basal ganglia and thalamus resting state. The levels of N-acetylasparteine NAAn, choline complex Choline compoundsChoo, Myo-inositol Ion, lactate Lactate Lacs and creatine Cr were collected from the left and right sides of the three sites. The data were analyzed by SPSS 13.0 software. Results NAA / Cr levels in the right frontal cortex of the HC and SIB groups were significantly higher than those in the left frontal cortex of the BDD group (2.419P 0.000) and the left frontal cortex of the BDD and SIB groups (3.839P, 0.0293C, SIB) and the left frontal cortex (Lacr / Cr) of BDD group, BDD group and BDD group were significantly higher than those of BDD group and SIB group, and the level of NAA / Cr in left frontal cortex of BDD group was significantly higher than that of BDD group and SIB group. The level of NAA-Cr in left basal ganglia of HC group was significantly higher than that of HC group (4.797 7) and SIB group (P < 0.05). It was significantly lower than that in HC group (F3.973P ~ (0.026) group and HAMD24 item. There was a positive correlation between the age of HMD24 group and the right thalamic area of Lacar P _ (Cr) level and the number of episodes in the right thalamic region of the BDD group (r 0.526 ~ 0. 034 ~ 0. 034 ~ 0. 034) BDD group (P < 0. 05 26). There was a positive correlation between the level of Lacr / Cr in the left basal ganglia and the item of HAMD24 in the left basal ganglia of BDD group. There was a negative correlation between the left thalamic MI / Cr level and the level of NAA / Cr in the right basal ganglia of the BDI group. The level of NAA / Cr in the right basal ganglia was significantly lower than that in the BDII group (P 0.004). Conclusion at 1: 1, NAA decreased and Lac increased in the left basal ganglia and frontal lobe of SIB at rest, which may be referred to as an internal marker of BDD associated with BD in the left basal ganglia. The lesion of basal ganglia was more serious in the patients with BDI than in the patients with BDII.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R749.4

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相關(guān)期刊論文 前1條

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本文編號(hào)：2039974