颅脑不同区域磁共振波谱分析在精神分裂症中的价值

目的探讨质子磁共振波谱（1H—MRS）在精神分裂症中的诊断价值。方法采用点分辨解析采样方式对26例精神分裂症患者和25例健康志愿者的左右侧额叶、海马和丘脑行MRS检查，分析的代谢产物有N～乙酰天门冬氨酸（NAA）、肌酸（cr）、胆碱（Cho）及相互间比值在两组间的差别。结果精神分裂症患者在左额叶、右额叶、左海马、右海马、左丘脑和右丘脑的NAA／Cr分别为1．41±0．33、1．40±0．36、1．43±0．27、1．42±0．26、1．46±0．30、1．45±0．28，低于健康组对应位置，但差异无统计学意义（P〉0．05）；Cho／cr分另4为1．36±0．38、1．37±0．29、1．30±0．31、1．31±0．28、1．20±0．20、1．22±0．19，高于健康组对应位置，但差异无统计学意义（P〉0．05）；NAA／（Cho＋Cr）分别为0．60±0．14、0．61±0．16、0．62±0．20、0．63±0．23、0．66±0．18、0．66±0．21，明显低于健康组对应位置，且二组差异有统计学意义（P〈0．05）。精神分裂症患者NAA／Cr、NAA／（Cho＋Cr）的下降幅度和Cho／Cr的上升幅度，额叶〉海马〉丘脑。结论精神分裂症患者MRS改变，主要体现在NAA的下降和Cho的上升，对精神分裂症的诊断有一定的参考作用。

The value of msgnetic resonance spectroscopy in different cerebral regions in schizophrenia

0bjective To explore the diagnostic value of proton magnetic resonance spectroscopy ( 1H-MRS ) in schizophrenia. Methods Using point resolved acquisition mode, 26 schizophrenia patients and 25 healthy subjects underwent MRS examination nn the left and right frontal, hippocampus and thalamus. The metabolites of MRS including N-acetyl aspartate ( NAA ), creatine ( Cr ), and chohne ( Cho ) were analyzed and compared between the two groups. Results NAA/Cr in the left and right frontal, hippocampus, and thalamus was 1.41 ± 0.33, 1.40 ± 0.36, 1.43 ± 0.27, 1.42 ± 0.26,1.46 ± 0.30, and 1.45 ± 0.28, respectively in schizophrenia patients, which was lower than those in the healthy subjects, but with no significant difference ( P＞ 0.05 ), Cho/Cr was 1.36 ± 0.38, 1.37 ± 0.29,1.30 ± 0.31, 1.31 ± 0.28, 1.20 ± 0.20, and 1.22 ± 0.19, respectively, which was higher than those in the healthy subjects, whereas with no significant difference ( P＞ 0.05 ), NAA/( Cho+Cr ) was 0.60 ± 0.14, 0.61 ± 0.16, 0.62 ± 0.20, 0.63 ± 0.23, 0.66 ± 0.18, and 0.66 ± 0.21, respectively, which was lower than those in healthy subjects, with a significant difference ( P ＜ 0.05 ). In schizophrenia patients, the levels of NAA/Cr, NAA/( Cho+Cr ) decreased and Cho/Cr increased in the order of frontal to hippocampus and then to thalamus. Conclusions A decline in NAA and a rise in Cho are the main demonstration on MRS for schizophrenia patients, which plays a role in the diagnosis of schizophrenia.