目的探讨创伤后应激障碍(PTSD)患者双侧海马活体MR波谱(MRS)的特点,为创伤后应激障碍的诊断和病因学机制提供线索.方法应用多体素活体MRS成像技术,对12例PTSD患者和12例正常对照者进行波谱分析,检测双侧海马的N-乙酰天门冬氨酸(NAA),肌酸(Cr)和含胆碱化合物(Cho)峰值,并进行统计学比较.结果PTSD患者左侧海马的NAA/Cr比值明显低于正常对照组(F=9.99,P=0.006),Cho/Cr比值差异无统计学意义(F=0.36,P=0.55);右侧海马的NAA/Cr比值、Cho/Cr比值差异均无统计学意义(F=1.44,P=0.25).性别之间的波谱差异比较无统计学意义(F=0.56,P=0.82);年龄、受教育时间、PTSD症状严重程度与左侧海马NAA/Cr比值的相关系数分别为0.47、0.35和0.18,差异无统计学意义(P>0.05).结论PTSD患者左侧海马存在病理性变化,NAA/Cr比值低于正常人.
Objective To study the characteristic of in vivo MR spectroscopy (MRS) in right and left hippocampal regions of patients with posttraumatie stress disorder ( PTSD ). Methods ^1H-MRS was performed on the right and left hippocampal regions in 12 patients with PTSD and 12 normal controls. The peak values of NAA, Cr, and Cho were calculated by Funetool software, and the ratios of NAA/Cr and Cho/ Cr were compared between PTSD and the control. Results The NAA/Cr ratio of left hippocampal region in PTSD group was significantly lower than that in the control ( F = 9. 99, P = 0. 006 ) , but the Cho/Cr ratio in left hippocampal region had no difference between the two groups( F = 0. 36, P = 0. 55 ). Furthermore, the ratios of NAA/Cr and Cho/Cr in right hippocampal region had no significant difference between both groups ( F = 1.44, P = 0. 25 ). Demography factors and the severity of PTSD symptoms were not related to the abnormity of the NAA/Cr ratio of the left hippocampus in PTSD group. Conclusion The pathological abnormality might exist in the left hippoeampus in patients with PTSD, and the NAA/Cr ratio of the left hippocampus was lower than normal.