广泛性焦虑症首次发病患者治疗前后前额叶皮质及海马神经生化物质的变化

广泛性焦虑症首次发病患者治疗前后前额叶皮质及海马神经生
化物质的变化
童梓顺;肖攀攀;刘赟
【期刊名称】《临床精神医学杂志》
【年(卷),期】2015(25)1
【摘要】Objective:To infestigate the changes of neuro-biochemical in bilateral frontal lobe and hip-pocampus in first episode patients with generalized anxiety disorder( GAD)before and after tandospirone treat-ment. Method:Thrity-nine first episode GAD patients( GAD group ) were treated by tandospirone for 8 weeks. Before and after treatment,they were assessed by Hamilton anxiety scale( HAMA),and were examined by magnetic resonance proton spectrum analysis(1H-MRS)to detecte the lefels of n-acetylaspartate(NAA), choline-congtaining
compounds( Cho),glutamic acid compounds( Glx)and creatine compounds( Cr)in bilat-eral prefrontal lobe and hippocampus. The resules of 1 H-MRS were compared with 30 normoal congtrols( control group). Results:Compared to the control group,the ratios of NAA/Cr and Cho/Cr in right frontal lobe in the GAD group before treatment were remarkablely lower(P﹤0. 05 or P﹤0. 01),the Glx/Cr was remarkablely higher(P﹤0. 01);and after treatment,the ratios of NAA/Cr and Cho/Cr in right frontal lobe were remarkable-ly higher(P﹤0. 05 or P﹤0. 01). But the ratios of NAA/Cr,Glx/Cr,Cho/Cr in left frontal lobe and bilateral hippocampal before
and after treatment were not significantly different from those in control group. The scroe of HAMA was negatifely correlated with the ratios of
NAA/Cr and Cho/Cr(r= -0. 732),positifely correlated with the ratio of
Glx/Cr(r=0. 569)in the right frontal lobe in the GAD group(all P﹤0. 01). Conclusion:The neurons metabolic abnormalities in right frontal lobe exist
in early onset of GAD patients. The anti-anxiety effect of tandospirone is probably correlated with the regulation of abnormal metabolism of brain tissue.%目的：观察广泛性焦虑症（ GAD）首次发病患者坦度螺酮治疗前后双侧
前额叶皮质及海马神经生化物质的变化。

方法：对39例首发的GAD患者（ GAD 组）给予坦度螺酮治疗8周；分别于治疗前后进行汉密尔顿焦虑量表（ HAMA）评分及磁共振质子波谱分析（1 H-MRS）检测双侧前额叶及海马N-乙酰天门冬氨酸（ NAA）、谷氨酸复合物（ Glx）、胆碱复合物（ Cho）、肌酸（ Cr）水平；并与30名正常对照者（正常对照组）比较。

结果：治疗前GAD组右侧额叶
NAA/Cr、Cho/Cr值显著低于正常对照组（ P﹤0.05或P﹤0.01），Glx/Cr值明显高于正常对照组（ P﹤0.01）；治疗后右侧额叶NAA/Cr、Cho/Cr值显著高于
正常对照组（ P﹤0.05或P﹤0.01）；治疗前后左侧额叶及双侧海马各代谢指标
相对浓度与正常对照组差异无统计学意义。

相关分析显示，GAD 组 HAMA 总分
与右侧额叶NAA/Cr 呈负相关（r ＝－0.732），与Glx/Cr呈正相关（r＝0.569）（P均﹤0.01）。

结论：GAD患者发病初期即存在右侧前额叶神经元代谢异常；
坦度螺酮抗焦虑疗效可能与其调整脑组织代谢有关。

【总页数】4页(P23-25,26)
【作者】童梓顺;肖攀攀;刘赟
【作者单位】510370 广州市脑科医院广州市惠爱医院，广州医科大学附属脑科医院;510370 广州市脑科医院广州市惠爱医院，广州医科大学附属脑科医
院;510370 广州市脑科医院广州市惠爱医院，广州医科大学附属脑科医院
【正文语种】中文
【中图分类】R749.4
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