首发未治疗的精神分裂症患者不同脑区葡萄糖代谢水平∗

摘要

Objective To investigate the basic mechanisms of the pathophysiology of schizophrenia by observing local glucose metabolism in various brain regions in first-episode patients with schizophrenia. Methods Relative regional cerebral glucose metabolism was measured with fluorine-18 deoxyglucose (18F-FDG) positron emission tomography (PET) scan in 18 patients with first-episode untreated schizophrenia who met the diagnostic criteria in the 10th edition of the international classification of diseases (ICD-10) and in 18 healthy individuals. PET data were analyzed using Statis-tical Parametric Mapping ( SPM) and paired t-tests. Regional cerebral glucose metabolism was compared between the two groups. Results Compared with the normal control group, patients with schizophrenia exhibited significant regional cere-bral glucose metabolic abnormalities including increases of glucose metabolism in the left inferotemporal gyrus and left tem-poral fusiform gyrus, decreases of glucose metabolism in the right inferoparietal lobule, right supramarginal gyrus, left in-feroparietal lobule, right postcentral gyrus and right supplementary motor area (P<0. 05). Conclusion A reciprocal glu-cose metabolism pattern is revealed untreated patients with schizophrenia, with enhanced glucose metabolism in the tempo-ral lobe and reduced glucose metabolism in the parietal lobe and the frontal lobe.%目的：通过观察首发未治疗的精神分裂症患者不同脑区葡萄糖代谢水平,探讨精神分裂症的病理生理学基础。方法纳入符合国际疾病分类标准第10版的首发未治疗的精神分裂症患者18例(观察组),同时选择和观察组年龄和性别相匹配的健康志愿者18人,分别进行正电子发射断层( PET/FDG, position emission tomography/18F-氟代脱氧葡萄糖)扫描,利用参数统计图(SPM)将两组进行配对t检验,分析两组间脑局部葡萄糖代谢差异。结果观察组左颞下回、左颞叶梭状回葡萄糖代谢水平升高,右侧顶下小叶、右侧顶叶缘上回、左顶下小叶、右侧中央后回、右侧额叶辅助运动区葡萄糖代谢水平明显低于健康志愿者,差异均有统计学意义( P<0．05)。结论首发未用药精神分裂症患者不同脑区葡萄糖代谢水平不同,其中颞叶代谢增高,顶叶、额叶代谢降低。