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卒中后抑郁患者小脑磁共振波谱成像改变的临床研究
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卒中后抑郁患者小脑磁共振波谱成像改变的临床研究
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Journal Article
卒中后抑郁患者小脑磁共振波谱成像改变的临床研究
2016
Overview
目的应用氢质子磁共振波谱成像（1H-MRS）技术,探讨卒中后抑郁（PSD）患者小脑代谢的改变及其与抑郁严重程度的关系。方法以卒中患者作为研究对象,回顾性收集人口学、个人疾病史和生活方式的数据,对40例卒中患者及20例健康志愿者进行自评抑郁量表（SDS）和汉密尔顿抑郁量表（HAMD）评分。根据评分结果,将卒中患者分为卒中后抑郁（PSD）组和卒中后无抑郁（CONT）组。对PSD组、CONT组和正常对照（NORM）组进行T1WI、T2WI、DWI及1H-MRS检查,评估脑梗死体积和脑白质病变部位及严重程度,测定小脑半球N-乙酰天冬氨酸（NAA）/肌酸（Cr）、胆碱复合物（Cho）/Cr、Cho/NAA比值,并分析卒中后小脑代谢改变与HAMD评分间的关系。结果 CONT组双侧小脑NAA/Cr、Cho/Cr、Cho/NAA比值与NORM组比较差异均无统计学意义（P〉0.05）。与NORM组和CONT组比较,PSD组病灶对侧小脑Cho/Cr、Cho/NAA比值均较高（P〈0.05）,病灶同侧小脑Cho/Cr、Cho/NAA比值差异无统计学意义（P〉0.05）,而双侧小脑NAA/Cr比值差异无统计学意义（P〉0.05）。PSD组家庭APGAR问卷评分、ARWMC总分、发病14d时NIHSS评分、病灶对侧小脑Cho/Cr和Cho/NAA比值与CONT组比较差异有统计学意义（P〈0.05）。多重线性回归分析显示,病灶对侧小脑Cho/Cr、Cho/NAA比值与HAMD评分具有相关性（P〈0.05）。结论小脑可能参与了卒中后抑郁的发生。
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