【作者】 丁松柏；

【导师】 赵汉清；

【作者基本信息】 第二军医大学 ， 精神病与精神卫生学， 2012， 硕士

【摘要】 磁共振波谱（MRS）是一种独特的技术，可以直接评估在大脑中的各种生化代谢产物的浓度。它除了具有非侵入性，较高的空间分辨率，还不需要放射性示踪剂，也不会有电离辐射，故较其他成像有独特的优势。因此常常被用来在不同的神经精神障碍，如抑郁症、精神分裂症等分子病理生理学研究。目前MRS检查的脑代谢产物主要有：N-乙酰天门冬氨酸(NAA)、胆碱化合物（Cho）、肌酸(Cr)等。研究方法采用横断面病例-对照研究设计。（1）第一部分研究，应用MRS成像系统检测15例青少年自杀未遂抑郁症患者和15名健康对照的双侧额叶白质、海马NAA、Cho、Cr代谢产物，分别计算额叶、海马双侧NAA／Cr、Cho／Cr比率，分析患者组和对照组之间代谢指标的组间差异。（2）第二部分研究，应用MRS成像系统检测13例青少年自杀未遂精神分裂症患者与14例青少年无自杀精神分裂症患者和15名健康对照的双侧额叶白质NAA、Cho、Cr代谢产物，分别计算双侧额叶白质NAA／Cr、Cho／Cr比率，分析患者组和对照组之间代谢指标的组间差异。结果（1）第一部分，青少年自杀未遂抑郁症组左侧额叶白质NAA／Cr(1．66±0．53)明显低于对照组(2．07±0．50)（P<0.05）；左侧海马Cho／Cr(1．34±0．50)明显高于对照组(0．98±0．34)（P<0.05）。（2）第二部分，青少年自杀未遂精神分裂症患者双侧额叶白质NAA／Cr、Cho／Cr与无自杀精神分裂症患者和健康对照对照之间无差异。结论（1）第一部分，青少年自杀未遂抑郁症患者存在左侧额叶神经元活力下降，左侧海马细胞膜代谢异常。（2）第二部分，青少年自杀未遂精神分裂症患者双侧额叶代谢功能无明显改变。更多还原

【Abstract】 Magnetic Resonance Spectroscopy (MRS) is a unique technique that can directly assess the concentration of various biochemical metabolites in the brain. MRS in addition to being noninvasive has a high spatial resolution and requires neither radioactive tracers nor ionizing radiation—a distinct advantage over other imaging modalities. Thus, it is used in the study of molecular pathophysiology of different neuropsychiatric disorders, such as, the major depressive disorder schizophrenia.These metabolites include N-acetylaspartate (NAA), choline-containing compounds(Cho),creatine (Cr), et al.Methods (1)The frist study objective to identify the possible alterations of brain functioning in prefrontal white matter and hippocampus in youths with suicide-attempted depression using MRS. MRS was performed on prefrontal white matter and hippocampus in15youths with suicide-attempted depression and15healthy controls. The NAA, Cho and Cr were measured and the ratios of NAA/Cr and Cho/Cr were determined.(2)The second study objective to identify the possible alterations of brain functioning in prefrontal white matter in youths with suicide-attempted schizophrenia using MRS. MRS was performed on prefrontal white matter in13youths with suicide-attempted schizophrenia,14youths with non-suicidal schizophrenia, and15healthy controls. The NAA, Cho and Cr were measured and the ratios of NAA/Cr and Cho/Cr were determined.Results (1)The ratios of NAA/Cr in the left prefrontal white matter of the youths with suicide-attempted depression were significantly less than that of the healthy controls(P<0.05). The ratios of Cho/Cr in the left hippocampus of the youths with suicide-attempted depression were significantly higher than that of the healthy controls(P<0.05).(2) There were no significant differences in both the ratios of NAA/Cr and Cho/Cr in youths with schizophrenia and healthy controls.Conclusion (1)There might exist reduced neuronal function in left prefrontal.and abnormal turnover of membrane in left hippocampus in youths with suicide-attempted depression.(2) The metabolites such as NAA, Cho in white matter of frontal lobes were not significantly altered in suicide-attempted schizophrenia.更多还原