文章摘要
梁小丽，李新纯，张雪花，谢莉，肖慧琼，周志强，方政华，刘学军，李冬凤.1H-MRS评价精神分裂症幻听患者扣带回代谢物比值[J].神经损伤功能重建,2021,16(9):502-505
1H-MRS评价精神分裂症幻听患者扣带回代谢物比值
1H-MRS Evaluation of Cingulate Gyrus Metabolite Ratios in Schizophrenia Patients withAuditory Hallucinations
  
DOI：
中文关键词: 精神分裂症  幻听  1 H-MRS  扣带回
英文关键词: schizophrenia  auditory hallucination  1 H-MRS  cingulate gyrus
基金项目:湖 南 省 自 然 基 金 （No. 2019JJ80096， 2019JJ80028，2019 JJ80025）； 湖南省中医药科研 计划项目（No. 201 924，201939，20200 31）； 湖南省卫生计生委 科研课题（No. C20 19038，2020817，2 0201050）； 湖南省脑科医院院 级课题（No. 2018B 04）
作者单位
梁小丽，李新纯，张雪花，谢莉，肖慧琼，周志强，方政华，刘学军，李冬凤 湖南省脑科医院精 神科，湖南中医药 大学临床医学院 
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中文摘要:
      目的：基于1 H-MRS探讨精神分裂症幻听患者扣带回各代谢物比值改变。方法：精神分裂症患者30 例，根据PANSS中P3值，分为无幻听组（P3值≤3分）15例和幻听组（P3值>3分）15例，另选择同期健康受 试者15例为对照组。3组均行扣带回1 H-MRS扫描，比较3组扣带回的N-乙酰天门冬氨酸（NAA）/[胆碱复 合物（Cho）+肌酸（Cr）]、NAA/Cr、NAA/Cho和Cho/Cr比值，分析精神分裂症幻听患者扣带回各代谢物比值 与病程、发病年龄及幻听分值的相关性。结果：幻听组的NAA/(Cho+Cr)、NAA/Cr、NAA/Cho低于对照组 （P<0.05）、无幻听组（P<0.05），且无幻听组以上指标均低于对照组（P<0.05）；而3组间Cho/ Cr相比无统计学 意义（P>0.05）。扣带回NAA/(Cho+Cr)、NAA/Cr比值与幻听分值明显相关（P<0.05），Cho/ Cr比值与幻听分 值无相关性（P>0.05）；NAA/(Cho+Cr)、NAA/Cr、NAA/Cho与发病年龄、病程无明显相关性（P>0.05）；Cho/Cr 与发病年龄相关（P<0.05），与病程、幻听分值无相关性（P>0.05）。结论：精神分裂症幻听患者扣带回存在显 著的代谢异常，扣带回可能作为传导通路的一个环节，与幻听发生可能有密切的关系。
英文摘要:
      To observe metabolite ratio changes in cingulate gyrus of schizophrenia patients with auditory hallucinations using 1 H-MRS. Methods: According to the P3 item score of the PANSS, 30 schizophrenic patients were divided into non-auditory hallucination (NAH) group (P3≤3) and auditory hallucination (AH) group (P3>3) with 15 patients in each. And 15 healthy subjects were enrolled as control group. The N-acetylaspartic acid (NAA)/[choline complex (CHO) + creatine (CR)], NAA/Cr, NAA/CHO, and Cho/Cr ratio in the cingulate gyrus in the 3 groups were compared by 1H-MRS scanning. The correlation between the metabolite ratios in the cingulate gyrus of schizophrenia patients experiencing auditory hallucinations and the course of disease, age of onset, and auditory hallucinations score was analyzed. Results: NAA/(CHO+CR), NAA/Cr, and NAA/Cho in the AH group were significantly lower than those in the control group (P<0.05) and NAH group (P<0.05); furthermore, the indexes in the NAH group were all lower than those in the control group (P<0.05). There was no significant difference in CHO/Cr among the three groups (P>0.05). NAA/(CHO + CR) and NAA /Cr ratios in the cingulate gyrus were significantly correlated with auditory hallucination score (P<0.05), and the CHO/Cr ratio was not correlated with auditory hallucination score (P> 0.05). NAA/(CHO+CR), NAA/Cr, and NAA/Cho were not correlated with age of onset and course of disease (P>0.05). CHO/Cr was correlated with age at onset (P<0.05) but not with course of disease and auditory hallucination score (P>0.05). Conclusion: Schizophrenia patients with auditory hallucinations have significant metabolic changes in the cingulate gyrus. The cingulate gyrus may serve as a link in the conductive pathway involved in the pathogenesis of auditory hallucination.
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