中文摘要：

目的探讨难治性抑郁症患者双侧海马磁共振质子波谱（^1H．MRS）的代谢特点。方法运用^1H-MRS成像系统检测16例难治性抑郁症患者（患者组）和16名健康对照者（对照组）双侧海马的N．乙酰天门冬氨酸（NAA）、胆碱复合物（Cho）、肌醇（mI）及肌酸（Cr）4种代谢产物，分别计算双侧NAA／Cr、Cho／Cr及ml／Cr。采用配对t检验、独立样本t检验及偏相关分析进行统计处理。结果对照组左侧海马NAA／Cr（1．43±0．19），明显高于右侧（1．21±0．10），P〈0．01。患者组双侧海马NAA／Cr的差异无统计学意义（P〉0．05），右侧海马NAA／Cr（1．44±0．31），明显高于对照组（1．21±0．10），P〈0．01。未发现患者组海马的任何代谢指标与病程及汉密尔顿抑郁量表（17项）评分的相关性（P〉0．05）。结论难治性抑郁症患者右侧海马代谢增强，双侧海马NAA／Cr不对称性消失。

英文摘要：

Objective To investigate the metabolic features of bilateral hippocampi in patients with treatment-resistant depression（TRD） by using proton magnetic resonance spectroscopy （^1H-MRS）. Method ^1H-MRS was performed on bilateral hippocampi in 16 right handed patients with TRD and 16 age-, sex-, and education-matched right handed healthy controls. The ratios of N-acetylaspartate （NAA）/creatine （Cr）, choline-containing compounds/Cr and myoinositol/Cr were calculated. Two-tailed Student＇s t test and partial correlation analysis were used for statistic process. Results The ratio of NAA/Cr in the left hippocampus was significantly higher than in the right hippocampi in controls （P 〈 0. 01 ）, while there were no significant difference on NAA/Cr between bilateral hippocampi in patients with TRD （P 〉 0. 05 ）. The ratio of NAA/Cr in the right hippocampus was significantly higher in patients than that in controls （P 〈 0. 01 ）. No relationships were found between all the metabolic indexes and the duration of illness or the score of 17-item Hamilton Depression Scale （P 〉 0.05 ）. Conclusion The asymmetry of the NAA/Cr ratio in the bilateral hippocampi in patients with TRD disappears due to the enhanced metabolism of the right hippocampus, which may be a trait for TRD.