【摘要】：背景：抑郁癥是一種常見的情感性精神疾病，具有高發(fā)病率，高復(fù)發(fā)率，高致殘率，高致死率、低治愈率的特點(diǎn)，嚴(yán)重的危害了人類的身心健康，極大地增加了社會(huì)的經(jīng)濟(jì)負(fù)擔(dān)。目前，針對(duì)抑郁癥的研究涉及眾多的學(xué)科，但是沒有得到統(tǒng)一的結(jié)論。目的:運(yùn)用磁共振彌散張量成像技術(shù)，利用基于纖維束示蹤的空間統(tǒng)計(jì)（tract-based spatialstatistics，TBSS）分析方法分析首發(fā)未用藥青年重性抑郁癥患者的彌散張量成像（diffusion tensor imaging，DTI）數(shù)據(jù)，探討首發(fā)未用藥青年抑郁癥患者的腦白質(zhì)微結(jié)構(gòu)和纖維連接異常，探討抑郁癥可能的發(fā)病機(jī)制。方法:納入32例（11男，21女）符合DSM-IV重性抑郁障礙診斷標(biāo)準(zhǔn)的重性抑郁患者和55例年齡、性別相匹配的健康人，進(jìn)行17項(xiàng)漢密爾頓抑郁量表(17-items of Hamilton Depression Scale，HAMD-17)和貝克抑郁自評(píng)量表（Beck Depression Inventory，BDI）評(píng)定。要求抑郁組患者HAMD-17評(píng)分＞18分， BDI＞8分；對(duì)照組HAMD-17評(píng)分＜8分，BDI評(píng)分≤4分。對(duì)兩組研究對(duì)象進(jìn)行DTI掃描，采用TBSS分析法，比較抑郁患者和健康對(duì)照組的腦白質(zhì)和纖維連接的各向異性分?jǐn)?shù)（fractional anisotropy，F(xiàn)A值）。結(jié)果:抑郁組的大腦左右中央前回，右側(cè)枕上回，右側(cè)額上回和右側(cè)島葉的白質(zhì)FA值低于正常對(duì)照組，（P＜0.05，體素大于50）；與之相對(duì)應(yīng)左右上縱束、右側(cè)下額枕束、右側(cè)鉤束和左右皮質(zhì)脊髓束的FA值低于對(duì)照組。結(jié)論：1、首發(fā)未用藥青年抑郁癥患者的額葉，顳葉，枕葉存在白質(zhì)損害。2、首發(fā)未用藥抑郁患者的左右側(cè)上縱束，右側(cè)下額枕束，，左右皮質(zhì)脊髓束、右側(cè)鉤束的纖維連接存在損害。3、抑郁癥患者的腦白質(zhì)微結(jié)構(gòu)和纖維連接異常在抑郁癥早期已經(jīng)出現(xiàn)。4、內(nèi)側(cè)前額葉皮質(zhì)—紋狀體—蒼白球—丘腦（medial prefrontal cortico-striato-pallido-thalamic，MPCSPT）神經(jīng)環(huán)路異常可能是導(dǎo)致抑郁癥發(fā)病的原因之一。
[Abstract]:Background: depression is a common affective mental disease, with high incidence, high recurrence rate, high disability rate, high mortality, low cure rate, serious harm to human physical and mental health. It has greatly increased the social economic burden. At present, the research on depression involves many subjects, but there is no uniform conclusion. Objective: to analyze the diffusion-weighted Zhang Liang imaging (diffusion tensor imaging,DTI) data of young patients with major depression without medication by using spatial statistics (tract-based spatialstatistics,TBSS) based on fiber tracer. To investigate the microstructures and fibrous connections of white matter in patients with first-episode untreated depression, and to explore the possible pathogenesis of depression. Methods: a total of 32 patients (11 men, 21 women) with severe depression who met the diagnostic criteria of DSM-IV and 55 healthy persons with age and sex matching were enrolled and 17 items of Hamilton Depression scale (17-items of Hamilton Depression Scale,) were administered. HAMD-17 and (Beck Depression Inventory,BDI). HAMD-17 score > 18, BDI > 8 in depression group, HAMD-17 < 8 and BDI 鈮

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