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精神分裂症患者药物治疗前后脑灰质体积的变化

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目的 探讨精神分裂症患者在抗精神病药物治疗前后其MRI脑灰质体积变化。方法 观察对象为2020年2月~2022年6月40例精神分裂症患者以及40名健康志愿者,设为观察组与对照组,均进行全脑灰质MRI检查,比较额上回、枕下回、顶上回等代表脑区脑灰质体积。观察组采用氯氮平治疗2个月,治疗前后进行阳性与阴性症状量表(PANSS)评估以及全脑灰质MRI。结果 观察组右侧额上回、左侧枕下回、左侧顶上回、右侧内侧扣带旁回、左侧中央后回脑灰质体积均显著低于对照组(P<0。05);观察组治疗后上述脑区脑灰质体积均显著低于治疗前(P<0。05);观察组治疗后PANSS量表阳性、阴性症状、精神病理评分均显著低于治疗前(P<0。05)。结论 精神分裂症患者存在局部脑灰质体积下降的现象,且抗精神病药物治疗后脑灰质体积进一步下降,精神症状的改善可能与脑灰质体积的下降没有关联。
The brain gray matter volume changes before and after antipsychotic treatment in patients with schizophrenia
Objective To investigate the changes in brain gray matter volume before and after antipsychotic drug treatment for schizophrenia patients.Methods Forty patients with schizophrenia from February 2020 to June 2022 and Forty healthy volunteers were the subjects of this study,and set up as observation and control groups.All underwent whole brain gray matter MRI.Brain gray matter volumes of representative brain regions such as superior frontal gyrus,inferior occipital gyrus,and superior parietal gyrus were compared.The observation group was treated with clozapine for 2 months,and the Positive and Negative Symptom Scale(PANSS)assessment and whole-brain gray matter MRI were performed before and after treatment.Results In the observation group,the volume of cerebral gray matter in the right superior frontal gyrus,left inferior occipital gyrus,left superior parietal gyrus,right medial cingulate parabra-chial gyrus,and left postcentral gyrus was significantly lower than that in the control group(P<0.05).The volume of cerebral gray matter in all brain regions mentioned above was significantly lower in the observation group after treatment than before treatment(P<0.05).Positive and negative symptoms and psychopathology scores of PANSS scale were sig-nificantly lower in the observation group after treatment than before treatment(P<0.05).Conclusion Patients with schizophrenia have a local decrease in brain gray matter volume and further decrease in brain gray matter volume after antipsychotic medication,and improvement in psychiatric symptoms may not correlate with the decrease in brain gray matter volume.

SchizophreniaAntipsychoticsBrain gray matterVolume

付华东、孙丽敏

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聊城市第四人民医院影像科(聊城,252000)

聊城市第四人民医院门诊药房

精神分裂症 抗精神病药物 脑灰质 体积

2024

国际精神病学杂志
中南大学

国际精神病学杂志

CSTPCD
影响因子:1.426
ISSN:1673-2952
年,卷(期):2024.51(3)
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