- 期刊
更年期婦女的憂鬱症在磁振頻譜上的表現
The Proton MR Spectroscopic Findings in The Menopause Women with Depression
摘要
使用氫原子磁振頻譜(proton magnetic resonance spectroscopy, ^1H MRS)的檢查，來評估更年期婦女罹患憂鬱症(depression)腦部的病況。自2004 年2 月至2005 年5 月間，共有15 位更年期的婦女到本部做頭部的磁振檢查，其中7 例是正常的更年期婦女；另外8 例在臨床上經精神科專家診斷有憂鬱症的症狀，對於這些受檢者，除了例行磁振檢查的脈衝序列外，我們另外用感興趣的體素(voxel of interest, VOI)定位在兩側的海馬回(hippocampus)各加做一組^1H MRS 的檢查。8 例有憂鬱症病患的^1H MRS，其兩側VOI 所呈現的NAA/Cr值有明顯的下降，代表有神經元的活動或功能產生障礙的現象。經過抗憂鬱症的藥物及心理治療後，憂鬱症的症狀均有明顯的改善，再到本部接受相同的磁振脈衝序列的檢查，可由MRS 得知，兩側的NAA/Cr 值有明顯的上升，其中右側在統計學上有顯著意義，表示神經元的活動或功能有改善的現象。與臨床的病程比較，我們發現有87.5% (7/8)的病例，用^1H MRS 的檢查來評估患有憂鬱症的更年期婦女恢復的情況，在臨床應用上，這是非常重要的訊息。因此^1H MRS 可以用來評估罹患憂鬱症的更年期婦女，在使用藥物治療前、後的腦部化學代謝物質其變化的情況，是一項非侵襲性又能提供臨床醫師重要訊息的診斷技術。
並列摘要
Using proton magnetic resonance spectroscopy (^1H MRS) to evaluate the brain condition of the menopause women with depression. We collected 15 cases of menopause women in this study from February 2004 to May 2005. Among these subjects, there were 7 cases of normal control and 8 cases with depression disorder which was confirmed by the clinic psychiatrist. In addition to routine MR pulse sequences, ^1H MRS was also done with the voxel of interest (VOI) located in bilateral hippocampus. The proton MRS of 8 cases with depression disorder, the decreased ratio of NAA/Cr indicate the impediment of the neuron activity and dysfunctions. Their symptoms of depression had obvious improvement after antidepressant treatment, and then we performed the same pulse sequences in our department again. The increased ratio of NAA/Cr indicate the improvement of the neuron activity and function in bilateral hippocampus with statistically significant difference in the right side. We correlated with the findings of MRS and the clinical course of the patients and found 87.5 % (7/8) of patients showing the correlation between the improvement of clinical course and the increased ratio of NAA/Cr. The proton MRS can evaluate the biochemical condition of the brain in the menopause women with depression before therapy and after antidepressant treatment. It is a non-invasive technique and provides useful information for the clinical psychiatrists.
延伸閱讀
- 李佩珊、李絳桃、黃久美、李奇龍（2006）。更年期婦女之更年期態度、更年期症狀與憂鬱情緒之相關性研究。實證護理，2(2)，156-165。https://doi.org/10.6225/JEBN.2.2.156
- 鄧振華（2006）。女性更年期憂鬱症中醫藥研究進展探討。中醫內科醫學雜誌，4(2)，14-28。https://doi.org/10.7102/JTCIM.200605.0014
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- 柯慧貞、周鉦翔（2009）。柯氏憂鬱量表應用於篩選國人更年期婦女憂鬱症之適用性。中華心理學刊，51(4)，471-481。https://doi.org/10.6129/CJP.2009.5104.05
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