【摘要】：目的探討首發(fā)抑郁癥患者是否合并嗅覺功能障礙,利用彌散張量成像(diffusion tensor imaging,DTI)技術研究嗅覺功能障礙首發(fā)抑郁癥患者腦白質(zhì)結(jié)構(gòu)改變及其與抑郁嚴重程度的相關性。方法選取本院2016年4月至2017年6月首發(fā)抑郁癥患者37例為研究組,同期性別、年齡及受教育程度相匹配的志愿者38例為對照組,均進行24項漢密爾頓抑郁量表(24-item Hamilton depression rating scale,HDRS24)評分;比較兩組嗅覺測試結(jié)果的差異。根據(jù)嗅覺測試結(jié)果,將研究組中17例嗅覺減退的首發(fā)抑郁癥患者列為研究A組,20例無嗅覺減退的首發(fā)抑郁癥患者為研究B組,分別對研究A組及研究B組進行DTI掃描,運用基于纖維束示蹤的空間統(tǒng)計分析方法(tract-based spatial statistics,TBSS)得到各向異性分數(shù)(fractional anisotropy,FA),比較研究A組與研究B組的顱腦FA值差異。結(jié)果與對照組比較,首發(fā)抑郁癥患者嗅覺測試值降低(P0.01);與研究B組比較,研究A組左側(cè)海馬、胼胝體膝部FA值降低(P0.01,FDR校正),未發(fā)現(xiàn)FA值顯著增加區(qū)域。研究A組嗅覺測試值與HDRS24量表評分呈負相關(r=-0.519,P=0.033),左側(cè)海馬、胼胝體膝部下降的FA值與HDRS24量表評分無顯著相關性(r左側(cè)海馬=0.163,r胼胝體膝部=-0.104;P0.05)。結(jié)論首發(fā)抑郁癥患者可合并嗅覺功能障礙;嗅覺功能障礙首發(fā)抑郁癥患者存在相關嗅覺通路的損害,但FA值下降與抑郁嚴重程度無顯著相關性。
[Abstract]:Objective to investigate whether patients with first-episode depression are complicated with olfactory dysfunction and to study the changes of white matter structure in patients with first-episode depression and their correlation with the severity of depression by using diffusion-Zhang Liang imaging (diffusion tensor imaging,DTI) technique. Methods from April 2016 to June 2017, 37 patients with first-episode depression in our hospital were selected as study group and 38 volunteers with matched sex, age and education level as control group. 24 items of Hamilton Depression scale (24-item Hamilton depression rating scale,HDRS24) were scored. The difference of olfactory test results between the two groups was compared. According to the results of olfactory test, 17 first-episode depressive patients with hypoolfaction in the study group were included in the study group A and 20 patients with the first episode depression without olfactory impairment as the study group B. DTI scans were performed on the patients in the study group A and the study group B, respectively. The anisotropic fraction (fractional anisotropy,FA) was obtained by using the spatial statistical analysis method (tract-based spatial statistics,TBSS) based on fiber tracer. The difference of brain FA between group A and group B was compared. Results compared with the control group, the olfactory test value of first-episode depression patients decreased (P0.01), compared with the study group B, the FA value of the left hippocampus and the genu of corpus callosum in group A was decreased (P0.01). No significant increase of FA was found in the patients with first-episode depression. In group A, there was a negative correlation between olfactory test value and HDRS24 scale score (r = -0.519). There was no significant correlation between the FA value of the left hippocampus and the genu of corpus callosum and the score of HDRS24 scale (r left hippocampus 0.163 r = -0.104% P 0.05). Conclusion the patients with first-episode depression may be complicated with olfactory dysfunction, and the patients with first-episode depression have related olfactory pathway damage, but there is no significant correlation between the decrease of FA and the severity of depression.
【作者單位】： 重慶醫(yī)科大學附屬永川醫(yī)院放射科;
【基金】：重慶市教委科學技術研究項目(KJ1702040) 重慶市科委基礎科學與前沿技術研究項目(CSTC2016jcyj A0217)~~
【分類號】：R445.2;R749.4

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