临床荟萃

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功能性消化不良伴抑郁、焦虑状态患者脑功能检查的临床分析

  

  1. 1.解放军第102医院 消化内科, 江苏 常州 213003; 2.苏州大学附属第三医院 干部一科,江苏 常州 213003
  • 出版日期:2017-09-05 发布日期:2017-09-08
  • 通讯作者: 通信作者:汪良芝,Email:wangdoc371@163.com
  • 基金资助:
    常州市卫生人才培养工程资助(2016CZBJ019)

Brain function in  patients with functional dyspepsia associated with depression and anxiety state

  1. 1.Department of Gastroenterology,  the PLA 102 Hospital,  Changzhou  213003,  China;
    2.Department of Geriatrics,  the Third Hospital Affiliated to Soochow University,  Changzhou  213003, China
  • Online:2017-09-05 Published:2017-09-08
  • Contact: Corresponding auther: Wang Liangzhi, Email: wangdoc371@163.com

摘要: 目的  研究功能性消化不良(FD)与精神心理因素的关系,探讨脑功能检查诊断FD伴抑郁焦虑状态患者的临床意义。方法 选取诊断为FD的100例患者及30例健康志愿者,进行宗氏焦虑自评量表(SAS)、宗氏抑郁自评量表(SDS)心理评估。分别行脑电图及脑电超慢涨落技术(ET)检查,比较FD组与对照组脑电图异常率及脑神经递质的差异。结果 FD组焦虑发生率为30%,抑郁发生率为33%,焦虑合并抑郁发生率为11%,对照组焦虑发生率为6.7%,抑郁发生率为10%,FD组SDS评分、SAS评分明显高于对照组(P<0.05)。FD患者组脑电图异常率35%,较对照组明显增高(P<0.05)。焦虑状态FD患者脑神经递质γ氨基丁酸(GABA)明显低于对照组,去甲肾上腺素(NE)、乙酰胆碱(Ach)、谷氨酸(Glu)高于对照组(P<0.05)。抑郁状态FD患者脑神经递质5羟色胺(5HT)、多巴胺(DA)明显低于对照组(P<0.05)。焦虑合并抑郁状态FD患者5HT、DA低于对照组,NE高于对照组(P<0.05)。单纯FD患者脑神经递质活动与对照组比较差异无统计学意义(P>0.05)。结论 FD患者抑郁焦虑状态发生率、脑电图异常率高于普通人群,可能与脑内神经递质变化,脑功能紊乱有关。

关键词: 消化不良, 抑郁, 焦虑, 神经递质

Abstract: Objective  To investigate  the relationship between functional dyspepsia(FD)  and mental psychological factors and explore the clinical significance of brain function check diagnosis on FD patients associated with anxiety and depression state. Methods  Psychological assessments, SelfRating Anxiety Scale(SAS) and SelfRating Depression Scale(SDS) were performed on 100 FD patients and 30 healthy volunteers. Electroencephalogram(EEG) and encephalofluctuo gram technology(ET) were also performed to compare  the abnormal rates and the differences of neurotransmitter between FD and control group. Results  Of 100 FD patients, the incidence rates of anxiety, depression and both anxiety and depression states were  30%, 33% and 11%, respectively.Of 30 healthy volunteers, the incidence rates of anxiety and depression were  6.7% and 10%, respectively. The scores of  SDS  and SAS  in  FD group were obviously higher than those of control group(P<0.05).EEG abnormal rate in  FD patient group was significantly  higher than that of control group, respectively  35% and 10%(P<0.05).Neurotransmitters γaminobutyric acid(GABA) activity was decreased much more in FD with anxiety state than that of control group,while norepinephrine(NE), acetylcholine(Ach) and glutamic acid(Glu)  activities were significantly  higher than those of control group (P<0.05). Neurotransmitters 5hydroxytryptamine(5HT) and dopamine(DA) were  much lower in FD patients with depression state than those of the control group (P<0.05). 5HT and DA were  lower in FD with anxiety and depression state than those of control group, but NE was significantly  higher than that of control group (P<0.05). There  was  no statistical significance in the difference of neurotransmitter activity between FD patients without anxiety and depression state and control group (P>0.05).Conclusion  The incidence rate of anxiety and depression state and the abnormity of EEG in FD patients are much higher than common people, the reason is due to the inordinate changes of neurotransmitter in the brain.

Key words: dyspepsia, anxiety;depression, neurotransmitter